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Whereas most unilateral masses are benign or nonfunctional, the bilateral adrenal mass is more likely metastatic disease, hemorrhage, infiltrative disease, congenital adrenal hyperplasia, macronodular Cushingâs syndrome, or bilateral cortical adenomas [ 5 ].n the case of the bilateral adrenal incidentaloma, patients who present with symptoms such as hypotension, dizziness, weight loss, or abdominal pain in the setting of bilateral adrenal masses should be evaluated for adrenal insufficiency using an ACTH stimulation test (Table 1).
The duplex demonstrated bilateral enlargement of the adrenal glands, and MRI of the abdomen showed high T2 intensity of bilateral adrenal masses with the right-sided mass measuring 4.3âcm and the left-sided mass measuring 2.8âcm (Figure 1.efinitive treatment for bilateral adrenal masses is surgical resection of both adrenal glands in most cases, except in the case of aldosterone secreting tumors, in which case medical options may be the preferred approach.