@entity9272 have been reported in @entity1 with @entity774 ( @entity774 ). ACTH excess, as seen with non-adherence to glucocorticoid therapy, may be responsible for @entity5 development. We report a case of a 51-year-old @entity1 with classic salt-wasting @entity774 managed on @entity229 7.5mg daily and @entity7842 who presented with @entity615 and was found to have giant bilateral retroperitoneal masses. On computed tomography (CT) imaging, the masses were heterogeneous, but contained predominantly low-density fat attenuation. The @entity5 were resected due to concern for malignancy and mass symptoms. Pathologic examination identified both retroperitoneal masses as @entity9272 . The left @entity5 was 34*20*13cm and weighed 4.7kg and the @entity5 was 20cm in the largest dimension. Adrenal tissue was present in the specimen. The @entity1 reported long-term compliance with glucocorticoid treatment. However, no biochemical monitoring of ACTH levels had occurred. Therefore, it is unclear if ACTH excess contributed to the development of these large @entity5 in this @entity1 . It was presumed that both adrenal glands were inadvertently removed during surgery and the @entity1 was treated with physiologic replacement doses of @entity701 and @entity7842 postoperatively. In this case, the bilateral adrenalectomy was inadvertent. However, adrenalectomy can be considered as a treatment option in @entity1 with classical @entity774 under certain circumstances to avoid complications of glucocorticoid excess. LEARNING POINTS: @entity9272 should be considered in the differential diagnosis of adrenal or retroperitoneal masses in @entity1 with @entity774 .On CT imaging, @entity9272 are seen as heterogeneous masses with low-density mature fat interspersed with more dense myeloid tissue. @entity9272 are usually unilateral and measure <4cm; however, very large and @entity5 have been reported.Treatment of @entity774 typically involves using supraphysiologic doses of glucocorticoid to suppress @entity774 . Bilateral adrenalectomy is an alternative treatment option in @entity1 with @entity774 .There is an association between ACTH excess and increased incidence of @entity9272 but the direct causal link remains to be established.

XXXX and inadvertent bilateral adrenalectomy in classic @entity774 .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'man'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'right tumor', 'tumors', 'bilateral tumors'] @entity229 :: ('MESH:D011241', 'Chemical') :: ['prednisone'] @entity615 :: ('MESH:D001416', 'Disease') :: ['chronic back pain'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['hydrocortisone'] @entity7842 :: ('MESH:D005438', 'Chemical') :: ['fludrocortisone'] @entity9272 :: ('MESH:D018209', 'Disease') :: ['adrenal myelolipoma', 'Myelolipomas', 'myelolipomas'] @entity774 :: ('MESH:D000312', 'Disease') :: ['adrenal hyperandrogenism', 'congenital adrenal hyperplasia', 'CAH']
@entity9272 :: (MESH:D018209,Disease) :: ['Giant myelolipomas']
