From 1973 to 1991, 13 patients [4 females (30%) and 9 males (70%)] were diagnosed with adrenal carcinoma at our hospital. The mean age at the time of diagnosis was 47.4 years (range 29 to 72 yrs). Eleven patients (85%) presented with abdominal symptoms and 8 (61%) with paraneoplastic syndrome. At the time of diagnosis, 3 (23%) had clinical or radiological signs of metastasis. Five patients (38.5%) had regional involvement and 5 (38.5%) had localized disease. The preoperative imaging studies disclosed an abnormal IVP in 8 of 13 patients (61%); 7 of 10 (70%) had an abnormal ultrasound scan and the CT scan was abnormal in 9 out of 9 patients (100%). Seventy-three percent of the tumors were classified as anaplastic or poorly differentiated carcinoma and 27% as differentiated carcinoma. Complete surgical excision was performed in 8 cases and op'DDD was administered in 4 cases. The five-year survival rate was 30%. We can conclude that early diagnosis, staging and histopathology have a significant effect on survival and surgical excision is the only treatment associated with medium or long-term survival.