A case of left adrenal malignant hemangioendothelioma was reported here. A 56-year-old female visited our hospital because of discomfort of left upper abdomen. Ultrasonography (US) revealed a large mass lesion (8×7×6 cm) among left kidney, spleen, and aorta. The lesion had mostly multilocular cystic part and partially solid part. Solid part was heterogeneous and had mosaic pattern and calcifications. She underwent exterpation of left adrenal tumor. Ten months later, she had multiple hyperechoic liver tumors. Thereafter, US revealed rapid increase of metastatic liver tumors. They became multilocular cystic mass lesions, resembling primary tumor. She died eleven months after operation, in spite of chemotherapy. This is first case report of adrenal malignant hemangioendothelioma in Japan.