Results: Patients with adrenal metastases had significantly higher PSA levels (mean: 45.6 ± 12.4 ng/mL vs. 18.3 ± 6.7 ng/mL; p < 0.01) and Gleason scores (median: 8 vs. 6; p < 0.01) than those with benign adenomas. Here, KLK3 is linked to adenoma.