We present a case of non-Hodgkins lymphoma located in both adrenal glands, with diminished adrenal reserve and fatal evolution with serious metabolic complications, with hypoglycemia, severe lactic acidosis, hyperuricemia, acute renal failure, hepatic affectation and hemogram alterations. Much of these complications can be explained by tumoral lysis syndrome probably prompted by the use of high doses of corticosteroids. Primary adrenal lymphoma is exceptional with only 14 cases described in the literature. In spite of its rarity it should be included in the differential diagnosis of uni or bilateral adrenal masses and an early diagnosis is necessary in order to avoid serious and potentially lethal complications. Percutaneous aspiration biopsy can be a valid method of diagnosis because it can identify specific tumoral antigens. The literature concerning this unusual tumour is reviewed.