Lowly differentiated neuroendocrine carcinoma of the adrenal gland is a malignant tumor that occurs in the adrenal tissue with hypersecretion of certain hormones. Neuroendocrine carcinoma (NEC) is a rare malignant tumor in urology, with varying incidence in different sites, and adrenal gland development is even rarer. The adrenal gland presents a low percentage of large cell type poorly differentiated neuroendocrine carcinoma, but it is highly malignant and generally has a relatively poor prognosis. Radical surgical resection is usually the mainstay in the early stage, and radiotherapy or chemotherapy or interventional therapy is usually needed in the advanced stage. As adrenal endocrine carcinoma has no obvious specific performance in imaging, it is often diagnosed by pathology after adrenal surgery, and the tumor is often accompanied by the change of adrenal secretion function, so it is necessary to pay attention to the change of hormone level in the body before and after the operation. It is recommended to go to a regular hospital to evaluate the condition and follow the doctor’s instructions to avoid delaying the condition.