Bilateral adrenal tumor: A case report and current challenges

INTRODUCTION: A bilateral adrenal tumor is a rare case. It differs significantly from unilateral adrenal mass since it is related strongly to genetic and family history. Adrenocortical Carcinoma might cause related hormonal syndromes such as Cushing syndrome, Conn syndrome, and virilization. AIM: This study aims to report an uncommon presentation of a 15-year-old female with bilateral Adrenal Tumor since an early age with virilization as the main symptoms. CASE PRESENTATION: The patient is a 15-year-old girl with female genitalia presentation. She complained of a bulging mass on her right flank with pain four years ago. The mass size grew progressively and initially painless. However, the patient started to feel pain a year ago. Since she was six years old, the mass started to appear on the left flank, and then it also started to appear on the right side. The mass appearance is simultaneous with virilization symptom development, such as the emergence of facial hair, mustache, and sideburns. In 2020, MRI showed a lesion on the right suprarenal with contrast enhancement with 14.5 × 11.5 cm in size, and a 5.6 × 4 cm recurrent left suprarenal lesion. The patient underwent right adrenalectomy resection surgery on January 21st, 2021. The immunohistochemistry examination suggested Adrenocortical Carcinoma. CONCLUSION: Adrenocortical Carcinoma is a hormone-secreting tumor that might affect the patient's condition systematically. Neglected cases of adrenal cortical carcinoma might affect secondary sexual organ development in the long term. Thus, an early diagnosis and treatment are paramount for this case.