Female patient aged 62 years, obese, diabetic and hypertensive for a year. For the last 6 months she has been complaining of sporadic, low-intensity right lumbar pain. Physical examination was normal. An abdominal ultrasound was performed, which showed a hypoechogenic right adrenal mass of 80mm, compressing the upper pole of the right kidney. A descending urogram showed an expansive process in the right adrenal gland, the upper pole of the right kidney was displaced downwards. On helical CT scan, tumour mass with a larger diameter of 8.7x76 cm with irregular contours, heterogeneous density of 100 - 37 HU, septate, compatible with adrenal tumour of fatty density. Figure 1

The hormonal study for cortisol determination was normal.
The patient underwent surgery via lumbar approach. Trans-operative findings were a tumour located in the right adrenal gland, well demarcated with irregular borders and lobulations. Right adrenalectomy was performed without complications. The patient's postoperative evolution was favourable and she remained asymptomatic.
The pathologist reported the specimen weighing 171.4 g, measuring 9 x 8 x 6 cm, with yellow-orange areas and other areas of haemorrhage and adipose tissue alternating with areas of calcifications. Histopathological examination: myelolipoma of the adrenal gland with extensive areas of calcifications.

