Introduction:
Adrenal incidentalomas are tumors found accidentally by imaging. Among the incidentalomas, hemangiomas are quite rare and in certain cases their surgical intervention should never be overlooked.
Presentation of case:
We present a case of 70 years old Lebanese female with an adrenal tumor presented as syncope found to have anemia on presentation and a bleeding 17 cm adrenal tumor on imaging. Patient had workup to rule out functioning adrenal tumors and decision to excise the tumor was taken after failure of embolization. Pathology report denied malignancy despite of the huge size and was in favor of hemangioma.
Conclusion:
Adrenal hemangiomas are rare and they rarely present as syncope. Attention to such a life-threatening condition should be sustained. Embolization is primarily implied but one should never neglect the failure rate and the need for surgical intervention.