[Pharmacological treatment in adrenal Cushing's syndrome.]

ACTH-independent adrenal Cushing's syndrome is the least common form of endogenous hypercortisolism. Recently, advances in genetics have allowed the description of several forms different to pathogenetic etiology, morphostructural characteristics and evolution towards the hypercortisolism. Alongside these, the adrenocortical carcinoma is also frequently responsible of a hypercortisolism clinical picture. The availability of steroidogenesis inhibitors, such as metyrapone and ketoconazole, provides to endocrinologist a therapeutic chance against different metabolic disorders sustained by hypercortisolism. Mitotane, an adrenolitic compound, is used alone in adjuvant therapy or in combination with different chemotherapy drugs in the treatment of adrenocortical carcinoma and in the treatment of severe Cushing's syndrome.