Malignant pheochromocytoma, still a therapeutic challenge.

For cases of malignant pheochromocytoma the prognosis is poor and experience with its treatment remains limited. We present a case of a hypertensive 16 year old woman with malignant pheochromocytoma and a good treatment response. Bone metastases appeared 6 months after the first resection. Local excision of the thoracic vertebrae metastases and palliative radiation therapy were performed, after which she received twelve cycles of cyclophosphamide, vincristine, and dacarbazine. Sixteen months later the patient remains asymptomatic without biochemical catecholamine activity.