Adrenal incidentalomas: Adrenal hemangioma in a patient with congenital adrenal hyperplasia

We describe a case of an adrenal incidentaloma in the setting of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. The adrenal mass was shown to be a cavernous hemangioma. Such neoplasms are rare but have the risk of retroperitoneal hemorrhage and may be difficult to differentiate from malignant adrenal tumors. The main consideration brought up by this case was that the simultaneous occurrence of an endocrinologically active disease such as CAH in association with a likely incidentaloma may lead to surgical intervention, due to the impossibility of being certain of its nonsecretory nature. Laparoscopic adrenalectomy allowed safe resection with no morbidity and a short hospitalization.