Laboratory investigations demonstrated severe hypokalemia and a high serum aldosterone level with low renin levels. Her recovery was uncomplicated. Management has continued with observation and chemotherapy, although a metastatic pulmonary lesion has developed. Adrenocortical adenocarcinoma is a lethal disease, requiring aggressive resection if possible. Chemotherapy and radiotherapy have given disappointing results, so recurrent disease is best managed by repeat resection also, if feasible.
Unresectable disease has a uniformly poor outcome.