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Adrenal myelolipomas are benign neoplasms consisting of hematopoieticcellular elements and adipose tissue. They are uncommon,found in 0.4% to 1% of the population at autopsy. Extraadrenalmyelolipomas (EM) are extremely rare with fewer than50 cases reported. We describe the first case of bilateral EM ofthe renal sinus. They are difficult to diagnose on imaging alonewhen arising in this location and biopsies may not yield a definitiveanswer. Management options include both conservativedoi:10.5489/cuaj.971 fatcat:2qw2mvhp6ve27aeibe5r5odxv4