Bilateral Adrenal Leiomyoma Presenting as Progressive Non-Functioning Adrenal Mass in a Young Female: A Rare Case Report

Abstract Background: Adrenal masses are increasingly detected with modern imaging, but adrenal leiomyomas (LMs) are exceptionally rare benign mesenchymal tumors. Bilateral involvement is particularly uncommon and often difficult to diagnose preoperatively. Case presentation: A 30-year-old female with celiac disease and chronic anemia presented with intermittent left flank pain. She had previously undergone right adrenalectomy for a lesion initially diagnosed as ganglioneuroma. Imaging revealed a progressively enlarging nonfunctioning left adrenal mass with atypical features. Hormonal evaluation was negative. Laparoscopic left adrenalectomy was performed, and histopathology confirmed bilateral adrenal leiomyoma. Conclusion: This case highlights the diagnostic dilemma of adrenal tumors, especially adrenal LMs and supports surgical excision for symptomatic or enlarging nonfunctioning adrenal masses.