A case of an adrenal mass which presented as spontaneous rupture contained by its own capsule is described. Clinical symptoms were aspecific and endocrinological examinations were within normal range. CT scan missed the presence of the adrenal tumor and interpreted the mass as a large haematoma arising from the left kidney. The pathological diagnosis was phaeochromocytoma. The management of "silent" phaeochromocytoma and its atypical presentation are discussed. A review of the international literature was also made collecting 29 cases of spontaneous rupture of an adrenal phaeochromocytoma.