The following is a summary of “Asymmetric Adrenals: Sexual Dimorphism of Adrenal Tumors,” published in the February 2024 issue of Endocrinology by Bechmann, et al.

Sexual dimorphism significantly impacts cancer incidence and survival rates, highlighting the crucial necessity for prompt and accurate diagnosis to enhance patient outcomes. For a study, researchers sought to elucidate the influence of sex and adrenal asymmetry on the emergence of adrenal tumors. 

Conducted across multiple centers, the observational study involved 8,037 patients diagnosed with various adrenal tumors, including adrenocortical carcinoma (ACC), aldosterone-producing adenoma (APA), cortisol-secreting adrenocortical adenomas (CSAs), non-aldosterone-producing adrenal cortical adenoma (NAPACA), pheochromocytoma (PCC), and neuroblastoma (NB). The investigation focused on determining tumor lateralization according to sex.

The findings revealed that ACC (n = 1,858), CSA (n = 68), NAPACA (n = 2,174), and PCC (n = 1,824) were more prevalent in females than in males, with female-to-male ratios ranging from 1.1:1 to 3.8:1. Conversely, NBs (n = 2,320) and APAs (n = 228) were less frequently observed in females (0.8:1). Moreover, ACC, APA, CSA, NAPACA, and NB were predominantly located in the left adrenal gland, with left-to-right ratios ranging from 1.1:1 to 1.8:1. In contrast, PCC predominantly originated in the right adrenal gland (0.8:1). Interestingly, both sexes exhibited a larger left adrenal gland compared to the right, with females generally having smaller adrenal glands than males. Furthermore, a comprehensive multiomics analysis of human adrenal tissues (n = 20) provided valuable insights into gene expression, catecholamine, and steroid contents within a single sample. A thorough review of imaging studies also corroborated consistent findings regarding adrenal gland size and asymmetry.

The findings underscored the potential contribution of adrenal asymmetry to the pathogenesis of adrenal tumors, emphasizing the importance of considering such asymmetry in the diagnostic process.

Reference: academic.oup.com/jcem/article-abstract/109/2/471/7255997