Single-cell resolution in adrenocortical carcinoma: from pathogenesis to treatment.

PURPOSE OF REVIEW: Single-cell technologies have transformed our understanding of common cancers, though remain limited in scope for rare disease. The purpose of this review is to describe the impact of these studies on adrenocortical carcinoma. RECENT FINDINGS: Pangenomic studies in adrenocortical carcinoma have revealed that this disease is comprised of distinct molecular subtypes with prognostic import. Recent, though limited, single cell studies in adrenocortical carcinoma have characterized a unique interplay between steroidogenic cancer cell populations and the immune system. SUMMARY: Studies to date suggest that adrenocortical carcinoma is comprised of heterogeneous populations that coexist in specific ecotypes, with distinct features that may contribute to intrinsic therapeutic resistance. To leverage translational potential of these findings, large-scale multiinstitutional studies, including spatial information, are needed.