We report the case of a 14 y.o girl treated with radiotherapy for an abdominal paraganglioma - rare pediatric abdominal tumor - with macroscopic tumoral residue after initial surgery and bone metastasis at diagnosis. Irradiation of the tumoral residue and adjacent vertebral metastasis was decided in national committee, proton or photon based-irradiations were compared, before choosing helical tomotherapy photonic irradiation to better protect kidneys. Response at three months was mixed, with mild regression on the tumoral residue contrasting with bone progression. The patient is now under screening to enter a prospective phase II trial of peptide receptor radionuclide therapy (PPRT).