A giant adrenocortical adenoma masquerading as retroperitoneal sarcoma: a rare diagnostic challenge

Retroperitoneal masses often mimic malignancy due to their size and imaging features; however, large benign lesions, such as nonfunctioning adrenocortical adenomas, can present similarly. A 46-year-old woman with abdominal distension and intestinal obstruction was found to have a large heterogeneous retroperitoneal mass on imaging, provisionally diagnosed as retroperitoneal sarcoma. Surgical excision and histopathology revealed a benign adrenocortical adenoma without hormonal activity. This case highlights the diagnostic difficulty in differentiating benign from malignant retroperitoneal tumors based on imaging alone and emphasizes the importance of considering adrenal adenomas in the differential diagnosis. Histopathology and multidisciplinary care are crucial for accurate diagnosis and effective treatment planning.