Two adult cases of incidental adrenal focal cytomegaly are presented. Neither of the patients involved had congenital malformations or symptoms attributable to adrenocortical dysfunction. In both, the histologic pattern was a cluster of giant cells resembling adrenal cytomegaly of the fetus or neonate. Similar to that in pediatric adrenal cytomegaly, the ultrastructure of these cells in adults suggests both cellular hyperactivity and exhaustion.