Preoperative localization of adrenal remnants.

Patients with recurrent Cushing's syndrome after bilateral adrenalectomy should have an adrenal scan prior to any attempt at repeat laparotomy. In those patients with a localized remnant on the adrenal scan and no evidence of a tumor of the pituitary gland, unilateral exploratory laparotomy should be considered for removal of the remnant. In our series of five patients fulfilling the aforementioned criteria, we have been successful in terminating the recurrence of Cushing's syndrome in these patients.