Asymmetric Adrenals: Sexual Dimorphism of Adrenal Tumors

Author:

Bechmann Nicole1ORCID,Moskopp Mats Leif2,Constantinescu Georgiana3,Stell Anthony4,Ernst Angela5,Berthold Frank6ORCID,Westermann Frank78,Jiang Jingjing9,Lui Longfei10,Nowak Elisabeth11,Zopp Stephanie11,Pacak Karel12ORCID,Peitzsch Mirko1,Schedl Andreas13ORCID,Reincke Martin11ORCID,Beuschlein Felix111415ORCID,Bornstein Stefan R3,Fassnacht Martin16ORCID,Eisenhofer Graeme3

Affiliation:

1. Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden , 01307 Dresden , Germany

2. Department of Neurosurgery, Vivantes Friedrichshain Hospital, Charité Academic Teaching Hospital , 10249 Berlin , Germany

3. Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden , 01307 Dresden , Germany

4. School of Computing and Information Systems, University of Melbourne , 3052 Melbourne , Australia

5. Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne , 50931 Cologne , Germany

6. Children's Hospital, University of Cologne , 50735 Cologne , Germany

7. Hopp Children's Cancer Center Heidelberg (KiTZ) , 69120 Heidelberg , Germany

8. Division of Neuroblastoma Genomics, German Cancer Research Center (DKFZ) , 69120 Heidelberg , Germany

9. Department of Endocrinology and Metabolism, Zhongshan Hospital , 200031 Shanghai , China

10. Department of Urology, Xiangya Hospital, Central South University , 410017 Changsha , China

11. Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich , 80539 Munich , Germany

12. Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health , Rockville, MD 20892 , USA

13. Université Côte d’Azur, Inserm, CNRS, Institut de Biologie Valrose , 06108 Nice , France

14. Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH) , 8091 Zurich , Switzerland

15. Institute of Neuropathology, University of Zurich , 8091 Zurich , Switzerland

16. Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital of Würzburg, University of Würzburg , 97080 Würzburg , Germany

Abstract

Abstract Context Sexual dimorphism has direct consequences on the incidence and survival of cancer. Early and accurate diagnosis is crucial to improve prognosis. Objective This work aimed to characterized the influence of sex and adrenal asymmetry on the emergence of adrenal tumors. Methods We conducted a multicenter, observational study involving 8037 patients with 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), and investigated tumor lateralization according to sex. Human adrenal tissues (n = 20) were analyzed with a multiomics approach that allows determination of gene expression, catecholamine, and steroid contents in a single sample. In addition, we performed a literature review of computed tomography and magnetic resonance imaging–based studies examining adrenal gland size. Results ACC (n = 1858); CSA (n = 68), NAPACA (n = 2174), and PCC (n = 1824) were more common in females than in males (female-to-male ratio: 1.1:1-3.8:1), whereas NBs (n = 2320) and APAs (n = 228) were less prevalent in females (0.8:1). ACC, APA, CSA, NAPACA, and NB occurred more frequently in the left than in the right adrenal (left-to-right ratio: 1.1:1-1.8:1), whereas PCC arose more often in the right than in the left adrenal (0.8:1). In both sexes, the left adrenal was larger than the right adrenal; females have smaller adrenals than males. Conclusion Adrenal asymmetry in both sexes may be related to the pathogenesis of adrenal tumors and should be considered during the diagnosis of these tumors.

Funder

Deutsche Forschungsgemeinschaft

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

Reference43 articles.

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