Purpose of review: To describe the significance of a common adrenal radiological finding on computed tomography or MRI.
Recent findings: Bilateral adrenocortical hyperplasia is the common expression of a variety of adrenal disorders, and its cause needs to be properly assessed in order to institute appropriate management.
Summary: Behind the radiological finding of bilateral adrenal enlargement, there is a spectrum of diseases that require diagnostic evaluation and management. Many cases are benign and not associated with abnormalities of endocrine function. However, these abnormalities may develop years after the initial diagnosis has been made.