This case highlights extensive progression of a relatively rare disease. In our case summary we highlight the progression of a bilateral adrenal hemangioma progressing to a size significant enough to cause
severe pain and partially compressing the IVC. Adrenal hemangiomas of this significance are rare, and mass effect to this degree is also an underreported phenomenon. To our knowledge this is the first case of
a symptomatic bilateral adrenal hemangioma causing mass effect.