Primary adrenal lymphomas (PAL) are rare occurrences with only less than 150 cases
reported in the literature. Two-thirds of these cases were reported in the last decade due to the
advancements in imaging techniques and immunohistochemistry. The non-specific signs and
symptoms have resulted in a delayed onset of symptoms and diagnosis of these tumors. Reports
of the results of chemotherapy are not gratifying, and most patients die within one year of the
diagnosis. We report a 65-year-old male with adrenal non-Hodgkin’s lymphoma (NHL), who
presented with hypercalcemia and renal failure. We reviewed all adrenal NHL cases presented
with hypercalcemia and attempted to comprehend its etiology and overall survival effect.