Adrenal myelolipomas are a benign and infrequent tumor, with adipose and hematopoietic composition; generally asymptomatic, in which the size varies from a few millimeters to some large ones that cause symptoms due to compression (mainly chronic and diffuse abdominal pain). We present the case of a 54 year old male patient with a long-term clinical course characterized by chronic abdominal pain, constipation and progressive volume increase, a large retroperitoneal mass was observed in the computerized tomography, so he underwent surgery for tumoral resection obtaining histopathological result of adrenal myelolipoma.