Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 12 2019 01 22 803 806 EN Azar Fanipakdel Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Yasamin Davoudi 2 Department of Radiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Seyed Alireza Javadinia Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mahdi Silanian Toosi Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2016 03 07 2017 01 04 Pheochromocytoma is a relatively rare tumor with no age preference. This tumor is usually diagnosed accidentally.  Pathologic fracture as the primary presentation of malignant pheochromocytoma is an uncommon presentation. The present case is a 23 year old man with malignant pheochromocytoma that his first chief complaint was bone pain due to pathological fracture. The presence of bone lesions as the first manifestation of pheochromocytoma makes this case a quite unusual one.  https://acta.tums.ac.ir/index.php/acta/article/view/5488 https://acta.tums.ac.ir/index.php/acta/article/download/5488/5199