We report what to the best of our knowledge is the first case of primary angiosarcoma of the adrenal gland. A 49-year-old woman, with blunt abdominal trauma, was admitted to our department. Computed tomography revealed a suspected rupture of a liver neoplasm and surgical treatment was performed. At laparotomy there was no evidence of liver tumour but a large mass was found in the right adrenal gland. The mass was removed along with the entire periadrenal fat tissue and locoregional lymph nodes. Microscopically, we found diffuse neoangiogenesis with large, hyperchromatic cells. This cellular proliferation, together with the widespread necrosis, distorted the normal appearance of the adrenal gland. No adjuvant therapy was administered. Six months and 1 year later thoracic- abdominal computed tomography and positron emission tomography were performed, and no signs of local recurrence or metastases were observed.
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