Adrenal cavernous hemangioma is a rare benign tumor, most commonly diagnosed incidentally on imaging studies. Hereby we report a case of adrenal cavernous hemangioma with myelolipoma in a 39-year-old female presenting with epigastric pain for six months. CT scan of abdomen and pelvis showed a 38*27 mm left adrenal mass with heterogeneous enhancement and calcification. Laparoscopic left adrenalectomy was performed and pathologic examination grossly showed an encapsulated oval mass with multicystic cut surfaces containing hematoma. Microscopically, blood filled dilated vascular channels lined by endothelial cells with foci of adipose tissue admixed with normal hematopoietic cells were seen. Positive immunostaining for CD31 and CD34 confirmed the diagnosis of cavernous hemangioma. So, cavernous hemangioma associated with myelolipoma of the adrenal gland should always be considered as a differential diagnosis of adrenal masses
