Laparoscopic adrenalectomy via transperitoneal and retroperitoneal approaches for bilateral giant adrenal myelolipoma: A case report and literature review.

Adrenal myelolipoma (AML) is a rare, benign neoplasm of the adrenal gland, typically asymptomatic and non-functioning. It is often detected incidentally during health checkups using B-ultrasound or computed tomography scans. Bilateral giant AMLs treated with combined abdominal and retroperitoneal laparoscopic adrenalectomy are rare. The present study reports on a 60-year-old male incidentally diagnosed with bilateral giant adrenal masses measuring 100x87x63 mm on the right and 75x52x33 mm on the left. The tumors were successfully excised using transperitoneal and retroperitoneal laparoscopic approaches, respectively. Histopathological examination confirmed the diagnosis of AML. The patient had an uneventful postoperative recovery and no signs of recurrence were observed during a 7-month outpatient follow-up. Although open radical adrenalectomy remains the standard treatment for giant AMLs (>6 cm), laparoscopic surgery offers distinct advantages, including reduced intraoperative bleeding, fewer postoperative complications and faster recovery. It may be suggested that both transabdominal and retroperitoneal laparoscopic approaches are safe and effective for giant AML resection. The choice of surgical method should be individualized based on tumor size, anatomical location and the surgeon's experience.