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The report emphasizes adrenal adenoma pathophysiology, the association between BWS and adrenal masses, and the treatment challenges presented by bilateral disease.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/clinical-management-of-bilateral-functional-adrenal-adenomas-case-report/456514/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/clinical-management-of-bilateral-functional-adrenal-adenomas-case-report/456514.png","ImageObject",300,407,{"name":42,"@type":43},"WPS_1790064749","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What pediatric condition and adrenal findings are described in the case report?","Question",{"text":63,"@type":64},"The report describes a pediatric patient with Beckwith Wiedemann Syndrome (BWS) who was found to have bilateral functional adrenal adenomas: one mineralocorticoid-secreting and one androgen-secreting.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the patient evaluated to characterize the adrenal masses?",{"text":68,"@type":64},"Workup included renal ultrasound, CT angiogram, MRI for further characterization, and PET scanning. Laboratory tests assessed hyperaldosteronism, pheochromocytoma, and adrenocortical carcinoma, along with relevant hormone levels.",{"name":70,"@type":61,"acceptedAnswer":71},"What treatment was performed and what was the result?",{"text":72,"@type":64},"The patient underwent staged surgical resection of both adrenal masses, which led to a marked reduction in hormone levels.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},456514,1791093103,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":55,"preview_page_count":4},3985747859154,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Journal of Surgical Case Reports, 2026, 1, rjaf1051  \n[https://doi.org/10.1093/jscr/rjaf1051](https://doi.org/10.1093/jscr/rjaf1051)  \nCase Report  \nCase Report  \nClinical management of bilateral functional adrenal adenomas  \nBrooks Melnyk 1 , Caitlin J. Cain-Trivette1 , Claire Gerall1 , Jee-Young Nina Ham2 , William Middlesworth1 , *  \n1 Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children’s Hospital, 3959 Broadway, New York, NY 10032, United States  \n2 Division of Endocrinology, Columbia University Vagelos College of Physicians and Surgeons / NewYork-Presbyterian Morgan Stanley Children’s Hospital, 3959 Broadway, New York, NY 10032, United States  \n*Corresponding author. Department of Surgery, Division of Pediatric Surgery, NewYork-Presbyterian Morgan Stanley Children’s Hospital, 3959 Broadway, New York, NY 10032, [United States. E-mail:](United States. E-mail: wm61@cumc.columbia.edu)[ wm61@cumc.columbia.edu](United States. E-mail: wm61@cumc.columbia.edu)  \nAbstract  \nAdrenocortical tumors are uncommon in the pediatric population. We report a case of a pediatric patient with Beckwith Wiedemann Syndrome (BWS) who was found to have bilateral functional adrenal adenomas: one mineralocorticoid-secreting and one androgensecreting. The patient ultimately underwent staged surgical resection of both masses, resulting in marked reduction in hormone levels. This case highlights the pathophysiology of adrenal adenomas, association between BWS and adrenal masses, and treatment challenges of bilateral adrenal masses.  \nKeywords: adrenal tumor; beckwith weidemann syndrome; adrenalectomy  \nIntroduction  \nAdrenocortical tumors are exceedingly rare in children, with about 25 cases diagnosed each year in the United States, 90% of which are functional tumors [1]. The incidence of bilateral adrenal lesions in the pediatric population is not well documented, but is reported to range from 17% to 22% in adults with incidentalomas [2] .  \nBWS is caused by an alteration in 11p15 and is associated with cancer predisposition. Adrenal tumors are the fourth most common following nephroblastoma, neuroblastoma, and hepatoblastoma [3] .  \nCase report  \nThis is a case of an 8-year-old male with BWS who presented to his primary physician with asymptomatic hypertension. Initial hospitalization and workup with renal ultrasound yielded no underlying etiology, but he was started on labetalol, spironolactone, and enalapril. He returned to the emergency department 2 weeks later with symptomatic hypertension with chest pain and headaches.  \nImaging workup included a renal ultrasound which revealed bilaterally elevated renal artery velocities and medullary calcinosis consistent with medullary sponge kidney. A subsequent  \ncomputed tomography (CT) angiogram which showed bilateral adrenal masses, no evidence of renal artery stenosis, and multiple enhancing lesions within the liver. Magnetic resonance imaging (MRI) of the abdomen for further characterization noted the right adrenal mass to be solid, homogenous, with restricted diffusion in the cortex measuring 2.4 × 2.4 × 2.3 cm; the left mass more heterogeneous, with small cystic components, restricted diffusion in the cortex but non-restrictive in the medulla measuring 2.0 × 2.3 × 2.0 cm . The liver nodules appeared to represent multiple areas of focal nodular hyperplasia (Fig. 1) . The patient had a positron emission tomography (PET) scan which revealed moderate fluorodeoxyglucose (FDG) avidity in the left adrenal mass (SUV 3 . 2) and low FDG avidity in the right mass (SUV 2 . 1) .  \nThe patient had laboratory testing for hyperaldosteronism, pheochromocytoma, and adrenocortical carcinoma. He was found to have elevated aldosterone levels at 47.5 ng/dL, aldosterone/renin ratio of 475, and electrolytes within normal limits. Plasma metanephrines, urine metanephrines, cortisol and vanillylmandelic acid were within","cbCaijR65OhSRlZ4","https://ap.wps.com/l/cbCaijR65OhSRlZ4","pdf",355054,"English","# Abstract\n# Introduction\n# Case report\n## Presentation and initial management\n## Imaging and laboratory evaluation\n## Surgical treatment and outcome","[{\"question\":\"What pediatric condition and adrenal findings are described in the case report?\",\"answer\":\"The report describes a pediatric patient with Beckwith Wiedemann Syndrome (BWS) who was found to have bilateral functional adrenal adenomas: one mineralocorticoid-secreting and one androgen-secreting.\"},{\"question\":\"How was the patient evaluated to characterize the adrenal masses?\",\"answer\":\"Workup included renal ultrasound, CT angiogram, MRI for further characterization, and PET scanning. Laboratory tests assessed hyperaldosteronism, pheochromocytoma, and adrenocortical carcinoma, along with relevant hormone levels.\"},{\"question\":\"What treatment was performed and what was the result?\",\"answer\":\"The patient underwent staged surgical resection of both adrenal masses, which led to a marked reduction in hormone levels.\"}]","Clinical management of bilateral functional adrenal adenomas - Case Report | PDF",1790746281]