Introduction:

Adrenal incidentalomas are clinically silent masses detected by imaging studies. Adverse effects are directly related to its functional component. The aim is to describe a case of adrenal incidentaloma with sudden hemodynamic disfunction.

Case report:

A 37-year-old male, history of diabetes and hypertension, referred for incidental finding of a tumor during computed tomography scan. Given the persistent hemodynamic instability, a laparotomy was performed, showing two lesions, one corresponding to the adrenal gland, the other ipsilateral pararenal space.

Results:

After surgery the patient remained in the Intensive Care Unit, with favorable outcome, and remission of symptoms. Histopathological report: malignant pheochromocytoma

Conclusion:

Malignant pheochromocytoma may produce hemodynamic dysfunction.