Bilateral adrenal tumors presenting with Cushing syndrome in the setting of horseshoe kidney: surgical and urological considerations (case report).

Simultaneous bilateral adrenal masses are less common in patients with Cushing syndrome (CS). This case report focuses on the clinical features, diagnostic workup, and treatment of a patient with bilateral adrenal tumors causing Cushing syndrome, with a horseshoe kidney. We report a case of bilateral adrenal tumors presenting with Cushing syndrome with a horseshoe kidney. Adrenalectomy was undertaken to manage the excess cortisol. Histopathological evaluation confirmed the diagnosis of adrenal cortical carcinoma (ACC). The preoperative cortisol level was 1750 nmol/L, which dropped significantly to 476 nmol/L following the treatment, showing clinical improvement, with a gradual regression of Cushing syndrome symptoms. A three-month postoperative evaluation revealed cortisol levels of 143 nmol/L. Surgical resection of these tumors has the potential to significantly improve clinical outcomes and alleviate the manifestations of Cushing syndrome.