Recently, we admitted a patient, Mr. Li, 55 years old, who was transferred from an outside hospital with a large left adrenal tumor. Mr. Li was hospitalized in the local people’s hospital 15 days ago due to vague pain in the left lumbar abdomen with recurrent fever, and was found to have a huge occupying lesion in the left adrenal gland. The local hospital doctor considered the risk of surgery too high and suggested Mr. Li to be transferred to a higher level hospital for treatment. After Mr. Li was transferred to our department, the director read the CT film carefully and considered that the huge malignant tumor of left adrenal gland with intra-tumor hemorrhage (25*15*12cm) could be clearly diagnosed by pathological examination after surgical resection; in addition, the tumor was huge and closely adhered to pancreas and spleen, the left diaphragm was protruded to the left thoracic cavity by the top of the tumor, the left lung lobe and heart were compressed by the tumor, so it might be necessary to enter the left thoracic cavity during surgery and remove It may be necessary to enter the left side of the chest cavity, remove the spleen and even part of the intestine and pancreatic tail to remove the tumor completely. The surgery is very traumatic, but without surgery, the tumor in the patient’s body will undoubtedly become a “time bomb”. After careful and adequate preoperative preparation, several professors from the Department of Anesthesiology, Cardiothoracic Surgery, and General Surgery agreed to assist our department to remove this rare and huge tumor if necessary to save the patient’s life by removing the “time bomb”. On August 24, 2012, with profound clinical experience and skillful surgical skills, the director personally performed the left adrenal giant tumor resection by using the hybrid cutting system energy platform, which is the most advanced surgical instrument in clinical open surgery, and weighed the tumor up to 2.56 kg after the surgery. The use of hybrid cutting system energy platform reduced the number of repeated sutures to stop bleeding during the operation and shortened the operation time, while stopping bleeding completely, no major bleeding occurred during the operation, no damage to the internal organs of the chest cavity and intestine, and preserved the spleen, pancreas and the intact diaphragm. Under the command of the director, the entire surgical team was clearly divided, closely cooperated and methodically organized, with every action of incision, separation and hemostasis accurately in place without the slightest error. After the operation, the patient recovered well and got out of bed. The postoperative pathology showed that the cortical adenocarcinoma (of the left adrenal gland) did not show any residual cancer cells on the cut edge. 1. Functions of adrenal glands The adrenal glands are a pair of flat organs located on both sides of the kidneys. They are composed of cortex and medulla, and the cortex can be divided into globular zone, fascicular zone and reticular zone from outside to inside. Cells in the globus pallidus produce the hormone “aldosterone”, which maintains sodium and potassium balance in the body and is also known as salt corticosteroid; cells in the fasciculus mainly synthesize glucocorticoids, which promote the metabolism of sugars, proteins and fats, and have a role in sodium and potassium retention and water volume regulation; cells in the reticular formation produce glucocorticoids and sex hormones. The medullary cells are called chromophores because of the brownish color of the granules oxidized by chromate. Chromophores can produce adrenaline, noradrenaline, dopamine and other substances, which are involved in the regulation of blood pressure. 2.Common types and clinical manifestations of adrenal tumors 1）Cortisolism mainly has chronic glucocorticoid increase leading to a group of clinical manifestations: full moon face, buffalo back, centripetal obesity, hirsutism, diabetic tendency, etc. 2) Primary aldosteronism Typical clinical manifestations are periodic muscle weakness with progressive increase in blood pressure and poor effect of common antihypertensive drugs. (3) Adrenal pheochromocytoma Pheochromocytes release adrenaline and norepinephrine in large quantities, these substances can cause vasoconstriction, increased heart rate, thus causing paroxysmal hypertension, progressive aggravation, and accompanied by severe headache, pale skin especially pale face, rapid heartbeat, tremors in the limbs and head, sweating, weakness, and sometimes chest tightness and shortness of breath, nausea and vomiting.