State-of-the-Art Treatment for Adrenal Tumors
The adrenal glands sit on top of the kidneys and have the size and shape of fortune cookies.
We take great pride in being a high-volume center dedicated solely to adrenal tumor disease and adrenal surgery. Dr. Carling has performed thousands of adrenal operations over his career, including more than 2,400 since January 2022 alone, so we have seen nearly every presentation of adrenal disease. We are completely dedicated to the mission of patient care, science and education. When it comes to patient care, we treat our patients as family members. From the day you call, email or contact us in any other way, you are part of our adrenal family. As you will see as you read through these pages, Dr. Carling has published widely on adrenal tumor disease and adrenal surgery.
How Are Adrenal Tumors Treated?
The right treatment depends on which hormone the tumor makes, whether one or both adrenal glands are involved, and what the tumor looks like on your scan.
- Mini Back Scope Adrenalectomy (MBSA). This is our preferred operation and we use it for more than 95% of our operations. It is done through small incisions in the back and typically takes about 20 minutes. The MBSA suits most tumors; very large tumors or known adrenal cancers may need a different approach, such as open surgery.
- Adrenal-sparing (partial) adrenalectomy. When possible, and especially when both adrenal glands have tumors, we remove the tumor and save normal adrenal tissue. When both glands need surgery we usually operate in two stages at least 6 weeks apart and preserve at least about 30% of one gland to avoid lifelong steroid dependence. Read more about adrenal-sparing surgery.
- Primary aldosteronism (PA, Conn's syndrome). When one gland is responsible, adrenalectomy cures the aldosterone excess in the large majority of patients. Medication (spironolactone or eplerenone) is appropriate for mild PA, PA from both glands, and patients who are not candidates for surgery.
- Adrenal hypercortisolism (AHC, formerly called MACS or subclinical Cushing syndrome). Adrenalectomy is the only cure and the first-line treatment. In mild AHC the decision is individualized, based on your cortisol-related health problems, age, surgical risk and preference.
- Pheochromocytoma. Surgery is the treatment, followed by lifelong annual follow-up with a metanephrine test.
- Tumors that make no hormones. Most are benign and do not need an operation, but every adrenal tumor needs hormone testing first.
Adrenalectomy recovery. After surgery for AHC, we test your cortisol the morning after the operation and give steroid replacement only if you need it. The other adrenal gland can take months to recover, and temporary steroid withdrawal symptoms (fatigue, aches, low mood) are common.
Why Patients Travel to Tampa for Adrenal Surgery
In today’s healthcare environment with increasing insurance premiums, cost of healthcare, and difficulty of access to healthcare, we believe that a center focused on a single group of diseases makes a real difference. Our focus on adrenal disease lets us reach the diagnosis with fewer tests and fewer visits. About half of our patients come from outside Florida, including from around the world.How is this possible? The reason we can do this is that we understand adrenal disease. Yes, knowledge is power. This may seem like an obvious concept. We do not order unnecessary lab tests, or expensive scans that provide no beneficial information. We arrive at the correct diagnosis and treatment faster, without wasting time and money for the patient and everyone involved. Experience is also the best way to keep the complication rate of adrenal surgery low.
Experience lets us work efficiently. We have done this before. We have seen it before. Dr. Carling personally performs every operation, up to 750 adrenal operations a year.
Adrenal.com and the Carling Adrenal Center are dedicated solely to adrenal disease. As you will learn, treatment of adrenal tumor disease and adrenal surgery are challenging for surgeons who rarely perform them, but straightforward, safe and fast if you have an experienced team and surgeon. The typical surgeon who performs adrenal surgery does about one adrenal operation per year, and outcomes are better with surgeons who do it regularly. You should have a high-volume adrenal surgeon perform your or your loved one’s operation.
We Created This Website for You!
The Carling Adrenal Center is one of the highest-volume adrenal surgery centers in the world.
We created this website to educate our patients, and we are completely dedicated to that mission. We are convinced that the more informed and educated the patients are about their disease, the better and more informed choices they will make for their health. In addition, it will make it so much easier for the patient to understand the signs and symptoms of their disease. Also, they will understand the pros and cons of various treatment options. Most importantly, when they understand the disease process, it will give them peace of mind.
We are also committed to enhancing the knowledge of the medical provider community--the doctors and nurses that take care of you. It is true that most doctors may see none, one or only a handful of adrenal tumor patients in their entire career. Although these might be great doctors, it is difficult to be an expert in something you may never have seen in your entire career. Adrenal.com is here to take the mystery out of understanding adrenal gland function, adrenal gland disease, adrenal gland tumors, adrenal cancer and all forms of adrenal gland surgery.
Remember, for most patients, the Mini Back Scope Adrenalectomy (the MBSA) is, in our view, the best operation.
What are some of the things you should know about adrenal gland surgery? Read more on our adrenal surgery blog
Last updated October 2026.