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Spontaneous rupture of pheochromocytoma is extremely rare, but it can be lethal because of dramatic changes in the circulation. A 44-year-old woman was hospitalized because of the sudden occurence of left loin and back pain with hypovolemic shock due to hypotension. Abdominal CT scan showed a hemorrhaging left adrenal mass surrounded by a massive hematoma. MOF developed and we decided to proceed conservatively because an emergency operation could be dangerous. The patient recovered from MOF and 122 days after the rupture, surgery was undertaken. 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