RESUMEN
INTRODUCTION: Low back ache is a common complaint in the elderly and in the absence of red flag symptoms can be easily dismissed as benign. Pheochromocytoma presenting as back pain is unusual and to our knowledge, only two previous cases have been reported in the literature with back pain as the 'only' presenting symptom. CASE PRESENTATION: We illustrate the case of an 85 year-old woman who presented with a 6 month history of back pain due to a very large Pheochromocytoma. This was incidentally picked up during a routine Lumbar spine plain radiograph and was noted to be a large Pheochromocytoma occupying the whole of the left abdomen. She required an open adrenalectomy to remove the large left adrenal tumour weighing 2.3 kg. CONCLUSION: Pheochromocytoma can present as a mimic of musculoskeletal conditions and hence due care should be exercised in assessing such presentations both in the young and elderly patients. Our patient is different from the other reported cases, as she is an 85 year-old and 'back pain' can be easily dismissed without investigating in such age groups, thereby missing serious conditions.