The lateralizing asymmetry of adrenal adenomas
Open accessAbstract
It is presumed that the incidence of adrenal adenomas is symmetric between the left and right adrenal gland; however, anecdotal observations suggest a potential lateralizing asymmetry. To investigate the symmetry in detection of adrenal adenomas and relevance to patient care. Cross-sectional and longitudinal studies. One thousand three hundred seventy-six patients with abdominal computed tomography or magnetic resonance imaging demonstrating benign-appearing adrenal adenomas. Location and size of adrenal adenomas. Left-sided adenomas were discovered in 65% of patients, right-sided in 21%, and bilateral adenomas in 14%. Among unilateral adenomas, 75% were left-sided. Left-sided adenomas were more prevalent than right-sided adenomas in each size category except the largest: <10 mm, 87%; 10 to 19 mm, 74%; 20 to 29 mm, 72%; ≥30 mm, 56% (P < 0.0001 for each category, except P = 0.19 when ≥30 mm). Among those with bilateral adenomas, the left-sided adenoma was significantly larger than the right one in 61% of patients (P < 0.001). There were no significant differences in the baseline prevalence or incidence of cardiometabolic diseases between patients with left-sided vs right-sided adenomas during 5.10 (4.2) years of follow-up. Adrenal adenomas are substantially more likely to be identified on the left adrenal than the right. This observation may be due to detection bias attributed to the location of the right adrenal, which may preclude identification of right-sided adenomas until they are substantially larger. These findings suggest the potential for an underrecognition of right-sided adenomas that may also impair the accurate detection of bilateral adrenal diseases.
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The authors of that study concluded that this detection bias may result in under-recognition of small (<30 mm) right-sided lesions and bilateral disease.
“The authors concluded that this detection bias may result in under-recognition of small (<30 mm) right-sided lesions and bilateral disease (90).”
From Adrenal incidentaloma (2020) · cites this paper as [90]
A recent large cross-sectional study of abdominal CT and MRI imaging in 1376 patients reported a higher detection of left-sided adenomas than right-sided adenomas in each size category except when the tumor size was ≥30 mm.
“Similarly, a recent large cross-sectional study of abdominal CT and MRI imaging in 1376 patients (90) reported a higher detection of left-sided adenomas than right-sided adenomas in each size category except when the tumor size was ≥30 mm.”
From Adrenal incidentaloma (2020) · cites this paper as [90]
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- Authors
- Hao, M., Lopez, D., Luque-Fernandez, M. A., Cote, K., Newfield, J., Connors, M., & Vaidya, A.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard School of Public Health, Boston, Massachusetts
- Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts
- Corresponding author
- Vaidya, Anand
- Venue
- Journal of the Endocrine Society
- Publisher
- The Endocrine Society
- Published
- 2018-03-16
- Volume
- 2
- Issue
- 4
- Pages
- 374-385
- ISSN
- 2472-1972 (ISSN-L)
- PMC
- PMC5887332
- OpenAlex
- W2793898091
- Cited by
- 40
- References
- 40
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 8 · 2021: 2 · 2020: 6 · 2019: 4
- FWCI
- 3.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of the Endocrine Society (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- Doris Duke Charitable Foundation (2015085)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK107407)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Pathology and Forensic Medicine › Soft tissue tumors and treatment
- Keywords
- adrenal adenoma, bilateral adrenal adenoma, adenoma size, detection bias, cardiometabolic disease, adrenal incidentaloma
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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