Brief Answer:
About Cushing Syndrome;

Detailed Answer:
Hello and thank you for asking!
I have gone carefully through your concern!
Biologically and radiologically it is approved that the remaining adrenal gland is having the same problem as the other one removed.
In 10% of cases the disease may be bilateral (in both glands).
In such great adenomas it is impossible to remove only the tumor and not the entire gland, so if there will be a decision to remove it, it will be adrenalectomy (the remove of the tumor together with the gland).
The surgeon can remove it through a standard operation or in some cases by using minimally invasive surgical techniques, with smaller incisions.

After the operation, you'll need to take cortisol replacement medications (lifelong) to provide your body with the correct amount of cortisol. The recovery period depends on the procedure. If you have an open adrenalectomy, you’ll probably stay in the hospital for four or five days. You can usually go home two to three days after a laparoscopic adrenalectomy. You’ll most likely feel some pain at the incision sites. If you have a laparoscopic adrenalectomy, you might also feel some cramping or bloating caused by the gas in your abdomen.
You may need some follow-up care if you encountered any complications from your surgery. However, most patients recover well and don’t experience complications. Generally, adrenalectomy patients can return to work as soon as they feel ready. However, doctors will tell you to avoid heavy lifting for six to eight weeks after surgery
Life expectancy is not altered if you adjust the replacement dose properly (as indicated by your physician) and follow the medical instruction of corticosteroid use in case of infections or stressful events.

Other treatment option is by using medications that block the corticosteroid production or its action.
Medications can be used to control cortisol production when surgery can not be performed or when it is refused.
Medications to control excessive production of cortisol at the adrenal gland include ketoconazole (Nizoral), mitotane (Lysodren) and metyrapone (Metopirone).

Mifepristone (Korlym) is approved for people with Cushing syndrome who have type 2 diabetes or glucose intolerance.
Mifepristone does not decrease cortisol production, but it blocks the effect of cortisol on your tissues.
It can be considered a rare condition, 5 person per million per year.

Hope i have been helpful.

Kind regards,
Dr.Mirjeta

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Brief Answer:
About adrenal replacement therapy;

Detailed Answer:
Welcome back,
As i mentioned before, the life expectancy is not changed if the Hydrocortison dose is adjusted properly.
There are studies that reveal 1 or 2 year lower life expectancy but is very important to be in continuous monitoring by a specialist physician.
Hydrocortison that is mostly used to substitute adrenal function, is a corticosteroid with low potency so do not worry about side effects. Of course if taken for long time without physician control, the symptoms of hypercotisolism may appear again.

In our days most of the hormones produced by our endocrine glands are easy to substitute.

Wish you good health.

Best wishes,
Dr.Mirjeta

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