A 53-year-old man was seen at the hospital because of upper abdominal pain. CT revealed a 3.5×2.2cm oval enhanced tumor shadow on the left adrenal head side. With an abdominal angiography, the feeding vessel was determined to be the left inferior phrenic artery.The retroperitoneal tumor was extirpated with a diagnosis of neurogenic tumor. During the operation, blood pressure (218/100) elevated with in serum epinephrine and norepinephrine to 3, 680pg/ml and 17, 716pg/ml, respectively, that demanded the management with α-blocker. Histopathologically it was diagnosed as paraganglioma. Twenty-nine per cent of these paragangliomas are malignant and easily infiltrate into nerves and vessels. The 5-year survival rate is 19% in malignant non-curative resection cases. At the present time when we do not have any reliable method to diagnose the malignant potential of the disease postoperatively, radical resection in an early stage would be essential. Further, since plenty of vessels in the lesion can cause intraoperative hypertension, management of such hypertension and tender manipulatin after have determined the anatomy of those vessels are important.