Giant Bilateral Myelolipomas in a Man with Congenital Adrenal Hyperplasia

摘要

A34-yr-old man presented with abdominal swellingand discomfort. Congenital adrenal hyperplasiahad been diagnosed as a neonate (homozygous forg.655A/C?G point mutation in CYP21A2). Duringadulthood,hewastreatedwithdexamethasone0.25mgtwice daily and fludrocortisone 0.1 mg once daily. Hedefaulted from adult clinic follow-up and had not col-lected his dexamethasone prescriptions for 1 yr. He suf-fered from epilepsy managed by a variety of anticonvul-sants, including enzyme-inducing drugs. He waspigmented and had a 20-cm mass palpable in the left ab-domen that extended across the midline. An ill-definedsmaller mass was palpable deep in the right abdomen.