Presentation and clinical patterns of bilateral adrenal lesions: a retrospective cohort study
Authors' conclusion
Most bilateral adrenal masses are benign and concordant; however, discordant or asynchronous disease identifies a higher-risk subgroup enriched for malignancy. Early contralateral lesion development and larger tumor size are key risk factors.
Study context
- Population
- Adults with bilateral adrenal masses, tertiary referral center, 2010–2025; median age 59.6 years, 51% women
- Participants
- 1,035 adults
- Exposure
- Asynchronous vs synchronous presentation; concordant vs discordant etiology
- Outcome
- Etiology, concordance, synchronicity, interval to contralateral lesion, and factors associated with discordance and malignant or pheochromocytoma contralateral lesions
Methodological detailssingle-centre, tertiary referral center
- Single-centre
- Tertiary referral center
Main finding
As reported in the abstract
- Concordant etiologies
- 85%
- Discordant etiologies
- 15%
- Concordant cases: bilateral benign cortical lesions
- 76%
- Discordant cases: benign
- 35%
- Discordant cases: malignant
- 31%
- Discordant cases: indeterminate
- 34%
- Synchronous presentation
- 84%
- Asynchronous presentation
- 16%
- Median interval to contralateral lesion, months (IQR 15-87)
- 45
Observational data: associations, not effects.
Further findings
Discordance
P = 0.001
Malignant lesions (bilateral malignant; discordant malignant) · value = bilateral malignant
overall P < .001
Discordant malignant
| Outcome | aOR (95% CI) | |
|---|---|---|
| Malignant or pheochromocytoma etiology among asynchronous casesInterval to contralateral lesion <2 yearsvs ≥5 years | 2.63 (1.01–6.85) | |
| 0.10.31310Adjusted odds ratio (log scale) |
Malignant or pheochromocytoma etiology among asynchronous cases
| aOR per mm (95% CI) | ||
|---|---|---|
| Larger tumor size | 1.06 (1.02–1.09) | |
| 0.512Adjusted odds ratio per mm (log scale) |
Original publication
Presentation and clinical patterns of bilateral adrenal lesions: a retrospective cohort study. J Clin Endocrinol Metab. Published 12 May 2026. doi:10.
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