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Treatment |
Adrenal etiology | Pituitary etiology | Ectopic ACTH secretion |
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Surgical |
– Adenoma/carcinoma: tumor resection – Macronodular or micronodular adrenal hyperplasia: resection of largest adrenal gland |
– Resection of pituitary tumor – Bilateral adrenalectomy in selected cases |
– Resection of primary tumor – Tumor debulking – Bilateral adrenalectomy in selected cases |
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Medical |
– Steroidogenesis inhibitors (ketoconazole, metyrapone, osilodrostat, mitotane, etomidate) – Glucocorticoid receptor antagonists (mifepristone) – Chemotherapy/mitotane for adrenal carcinoma |
– Second-generation somatostatin analogues (pasireotide) – Dopamine agonists (cabergoline) – Steroidogenesis inhibitors (ketoconazole, metyrapone, osilodrostat, mitotane, etomidate) – Glucocorticoid receptor antagonists (mifepristone) |
– Steroidogenesis inhibitors (ketoconazole, metyrapone, osilodrostat, mitotane, etomidate) – Glucocorticoid receptor antagonists (mifepristone) – Somatostatin analogues (octreotide/lanreotide) – Everolimus – Tyrosine kinase inhibitors – Chemotherapy |
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Radiotherapy |
External-beam radiation therapy for adrenal carcinoma |
Conventional versus stereotactic fractionated radiotherapy |
External-beam radiation therapy |
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Other specialized therapies |
Not applicable |
Not applicable |
– Hepatic artery embolization – Radiofrequency ablation – Peptide-receptor radiolabeled therapy |
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ACTH, adrenocorticotropic hormone. |
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