Adrenal myelolipoma (AM), with its unique histological appearance, is a rarely encountered benign tumor. It is mostly asymptomatic and is incidentally detected. Rarely, in some large masses, retroperitoneal hemorrhage, which could cause life-threatening shock due to spontaneous rupture of AM may develop. In this case report, we presented a 60-year-old male patient who was admitted with abdominal pain and rapid decline in hemoglobin values. Computed tomography (CT) showed bleeding into the retroperitoneal space secondary to the rupture of myelolipoma measuring 14-cm in diameter in the right adrenal gland. Emergency exploratory laparotomy was performed, and the mass was excised. The possibility of rupture, and bleeding of large adrenal myelolipomas should be taken into consideration and accordingly, follow-up of asymptomatic patients should be done carefully.

Keywords : adrenal myelolipoma, retroperitoneal hemorrhage, spontaneous rupture