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A 91-year old woman was referred to our hospital for evaluation of a palpable mass in the left hemiabdomen. A marked anemia was found on admission. Imaging revealed an inhomogeneous mass of the left adrenal gland with a diameter of 19 cm. Due to a lack of perfusion in contrast enhanced ultrasound and the clear delineation to neighbouring organs on CT scan, an adrenal hemorrhage was diagnosed.