A 37-year-old obese woman with a history of classic congenital adrenal hyperplasia was evaluated in the General Surgery outpatient consultation due to clinical signs of abdominal and lumbar pain, associated with great abdominal distention. An abdominal CT scan showed 2 large adrenal-dependent retroperitoneal masses that were displacing neighboring structures, which were well-demarcated and had patchy areas of fat density (Fig. 1). These findings were consistent with giant adrenal myelolipomas.
Given the compressive symptoms and size greater than 10 cm, which carries an increased risk of spontaneous rupture, surgery was indicated. The patient underwent scheduled bilateral adrenalectomy using a bilateral subcostal laparotomy (Fig. 2).
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