Stage IV 
TNM Any T, any N, M1 or T3-4, N1, M0 

Standard Treatment  The goal of treatment for an adrenocortical carcinoma that has spread to adjacent organs (a T4 tumor) or has metastasized to distant sites is palliation rather than cure.
    Chemotherapy with mitotane may lead to partial or complete remissions. Other treatment options are radiation therapy to bone metastases and/or the surgical removal of localized metastases, particularly those that produce hormones.

Five-Year Survival  Less than 1 percent 

Investigational 
• Clinical trials are appropriate for patients with metastatic disease or with recurrent cancer. 
• Cisplatin seems to benefit some patients with metastases and is being clinically evaluated.

Pheochromocytoma
Localized
Localized benign pheochromocytoma may be confined to one or both adrenal glands or situated in other (ectopic) locations.