Abstract Background Severe obesity is frequently associated with multiple co-morbidities, including hormonal imbalances and incidental adrenal masses. Multi-disciplinary approaches are often required for optimal patient outcomes. Case presentation We report the case of a 38-year-old female with a BMI of 62 kg/m2, presenting with severe obesity, irregular menses, and a large left adrenal incidentaloma. Her medical history includes GERD, OSAS, and prior diagnosis of endometrial intraepithelial neoplasia, which was managed conservatively. Imaging revealed a 40×30 mm adrenal mass with radiological features of a myelolipoma. The indication for adrenalectomy was based on the documented increase in size of the mass over time. PET-CT and hormonal evaluation confirmed this to be non-functioning. The patient underwent a successful laparoscopic sleeve gastrectomy with simultaneous left adrenalectomy with direct supragastric approach. Histopathology confirmed an adrenal myelolipoma. Postoperatively, the patient experienced significant weight loss (23 kg in 3 months), improved metabolic profile, and enhanced quality of life. She continues to be on nutritional supplementation and endocrinological follow-up. Conclusion This case highlights the importance of an integrated surgical and medical approach in managing complex obesity cases with adrenal incidentalomas. Hence, simultaneous sleeve gastrectomy and adrenalectomy can be safely performed with favorable outcomes in selected patients.
Mauro et al. (Thu,) studied this question.