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A 51-years-old male with malignant pheochromocytoma underwent resection of the right adrenal tumor in May 2007. The pathological diagnosis was pheochromocytoma, suspected of being malignant tendency, which contained neuroblastoma cells. Recurrence and metastasis was observed 4 years after the operation. During the treatment, 131 I-metaiodobenzylguanidine ( 131 I-MIBG) treatment, palliative cytoreductive surgery, somatostatin treatment, TKI (sunitinib) targeted therapy, combined chemotherapy wasdoi:10.15761/cmr.1000105 fatcat:es2i2xhtingdnmw6vbbhwcx2jy