Adrenal myelolipomas are rare,benign tumors consisting of hematopoietic and adipose tissues. Tumors exceeding 4 kilograms are very rare in literature. We report a case of right sided giant adrenal myelolipoma weighing 4.395 kilograms.

A 39 year old man presented with complaints of heaviness and swelling in right upper abdomen for six months. Physical examination revealed a large, non-tender, bimanually palpable mass.CT scan revealed a 25x20x13 cm, right suprarenal mass with features suggestive of adrenal myelolipoma. The tumor was biochemically inactive.Surgery was performed through a right subcostal incision.The tumor was completely excised. The patient had an uneventful hospital course and was discharged on third postoperative day.

Histopathological examination revealed a capsulated benign neoplasm composed of mature adipose tissue, admixed with hematopoietic elements. No atypia or mitotic activity or features of malignnacy were seen. Features were in favour of myelolipoma.

This case report highlights the clinical presentation of a rare adrenal tumor along with imaging modality to be used while making a diagnosis. It also highlights the fact that such large tumors can be resected completely with good outcome for the patient.