Adrenal masses are increasingly detected incidentally on imaging due to the widespread use of advanced imaging modalities and require a multidisciplinary approach for accurate diagnosis and management. This case report describes a patient who initially presented with lower extremity deep vein thrombosis and was found to have a right adrenal mass upon cross-sectional imaging. Atypical features noted on further imaging prompted investigation of the mass, with histopathologic analysis and PCR sequencing ultimately identifying Mycobacterium genavense infection as the cause. This case highlights the importance of maintaining a broad differential for incidental adrenal findings and the critical role of histopathology for definitive diagnosis.