We present a 55 years old lady having an unusual presentation of abdominal pain and a clavicular mass as the initial manifestations of a nonfunctioning malignant pheochromocytoma. Fine needle aspiration of the clavicular mass revealed a metastatic adenocarcinoma. A search for primary site revealed a mass in left adrenal and multiple space occupying lesions in the liver. The aspirations were identical to that from the clavicle. Surgical biopsy of the clavicular mass revealed, features of metastatic pheochromocytoma. Urinary catecholamine was normal. Malignant pheochromocytoma can present with atypical features and guided fine needle aspiration cytology can be a safe diagnostic procedure.