A series of 17 patients with primary adrenal cortical carcinoma is presented. Of 14 patients without evidence of disseminated disease prior to radical surgery, 6 developed distant metastases during follow-up. The mean interval free of disease in these patients was 12 months (range 3-40) and the median survival 15 months. Of the six patients in whom adjuvant external beam radiotherapy was delivered, no evidence of local recurrence was observed. Of the patients treated without external beam radiotherapy, 3 local failures were observed. The projected 5 years survival was 35%, which is similar to that reported in the literature. To date, there is no evidence that chemotherapy nor radiotherapy could improve the survival, however, radiotherapy might increase the local control in selected cases.