Describe a rare case of metastatic pheochromocytoma to thoracic vertebra and the neurosurgical management with palliative objective in the context of malignant pheochromocytoma. Up to 10% of pheochromocytomas can be malignant. Bone metastases are an usual site of dissemination with some reports of rates up to 71%. However, the involvement of vertebra its very rare, Liu et al reported that in November 2017 only exist 17 reported cases of vertebral metastases of malignant pheochromocytoma. Also, within the thorax the most common places for paragangliomas are the mediastinum and, in second place, the heart. For this kind of pheochromocytoma, the survival rate to five years is close to 40% to malignant, and there is no curative treatment, and do not exist reliable data about the improvement of survival rates given by surgical management of metastatic lesions, that is the reason why the surgical treatment is focus in prevent local complications given by the metastatic disease. This case is about a 40 year old male with previous diagnosis of pheochromocytima treated surgically in the past, who presented now with precordial pain. In diagnosis studies was ruled out cardiac disease, and confirmed progression of disease to sternum, and incidentally findings in T4 vertebra. The patient doesn’t present neurological symptoms. The case were presented in the weekly meeting for neurooncology decision making, in which was decided to perform a palliative surgery consisten in medullar decompression and arthrodesis two levels above and below the lesion. Surgical pathology revealed paraganglioma with chromaffin cells. Malignant pheochromocytoma is a rare entity, with common metastases to bone. Once the metastases is stablished, there is no curative treatment for the disease and the treatment should be focus to ameloriate the quality of life and prevent local complications, in this case, medullary compression.