Presentation
Routine follow-up.
Patient Data
Right adrenal mass 3 cm with a further anterior 1 cm nodule.
Lobulated left adrenal mass measuring 5 cm. Exophytic region of macroscopic fat superiorly.
Both demonstrate heterogeneous postcontrast enhancement. No calcifications. Non-nodular adrenal gland limbs are thickened.
No upper abdominal lymphadenopathy.
Fatty liver. Large midline infra umbilical anterior abdominal wall hernia.
Case Discussion
This patient had a known history of congenital adrenal hyperplasia after presenting with Addison disease at birth. Her congenital adrenal hyperplasia had been poorly controlled with the patient lost to follow-up. The adrenal changes are typical with background adrenal limb thickening with numerous adrenal masses and nodules, some containing macroscopic fat - these likely represent a combination of nodular hyperplasia, adenomas and myelolipomas.