A 6 cm pink-tan tumor with hemorrhagic areas replaces most of the adrenal parenchyma. The triangular area to the right of the tumor is normal adrenal cortex. About 10% of pheochromocytomas occur in children. The pediatric cases are less likely to be malignant and more likely to be bilateral and associated with MEN syndromes (2a and 2b). Pheochromocytoma is a rare tumor with an incidence of 1-2 cases per 100,000 individuals. Of all the adrenal masses detected incidentally, about 5% are pheochromocytomas.