{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T20:41:50Z","timestamp":1757623310506,"version":"3.44.0"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pheochromocytoma is a rare catecholamine\u2010producing tumor with metastatic potential. Recurrence after more than 40\u2009years is exceptionally rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>During evaluation for ischemic colitis, a 71\u2010year\u2010old woman was found to have multiple bone metastases, possibly linked to catecholamine excess. She had undergone left adrenalectomy for pheochromocytoma at age 25. Bone biopsy confirmed metastatic pheochromocytoma, and immunohistochemical findings were similar to the original tumor. Urinary metanephrine and normetanephrine were markedly elevated. She declined systemic therapy and has remained clinically stable for 6\u2009years, with her blood pressure well controlled on doxazosin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case illustrates a recurrence 46\u2009years after adrenalectomy, potentially representing the longest reported interval to date. It highlights the silent and indolent nature of some metastatic pheochromocytomas and underscores the necessity of lifelong follow\u2010up. The patient's stable course also emphasizes the clinical heterogeneity of metastatic pheochromocytoma and supports the need for individualized follow\u2010up and treatment strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/iju5.70086","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T22:24:16Z","timestamp":1755123856000},"page":"533-538","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Late\u2010Onset Bone Metastasis 46\u2009Years After Initial Surgery for Pheochromocytoma: A Case Report"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0736-4475","authenticated-orcid":false,"given":"Fumio","family":"Ishizaki","sequence":"first","affiliation":[{"name":"Department of Urology, Molecular Oncology, Graduate School of Medical and Dental Sciences Niigata University  Niigata 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