Paragangliomas are very rare neuroendocrine tumors of extra adrenal origin and they can be symptomatic sometimes and may require multi disciplinary approach.

We report a case of 42 year gentleman with no known comorbidities presented to us with the incidental finding of right supra renal space occupying lesion on ultrasound with no other symptoms. Magnetic Resonance Imaging of the abdomen revealed - 9x7cm retroperitoneal suprarenal soft tissue mass with tethering and engulfment of IVC, hyperintense in T2 with restricted diffusion. In PETCT right adrenal gland was visualised separately and it abuts segment VI of liver, caudate lobe, portal vein,duodenum, pancreas and pushing IVC anterolaterally. Normetanephrine was 3000ug/24hrs. The patient was started on medical management and underwent robot-assisted removal of the mass, without any intraoperative complications and uneventful postoperative recovery.

 

Robotic assisted surgery aids in removal of such functional tumors in complex locations in experienced hands without much intra-operative complications, with proper pre-operative planning and approach.