Unilateral adrenalectomy with excision of the adenoma or carcinoma is the treatment of choice. Metyrapone should be given several weeks or months prior to surgery to achieve clinical remission as this is associated with reduced peri-operative morbidity and mortality. Glucocorticoid replacement therapy may be necessary for several months or years afterwards as the patient is hypoadrenal.
Carcinomas are highly aggressive and should be treated postoperatively with radiotherapy and the adrenolytic drug o,p'DDD - mitotane.
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