Careful consideration of any accompanying clinical symptoms will determine the course of action. If symptoms worsen over time, the first surgery was probably not curative and a second surgery, pituitary irradiation (radiotherapy or radiosurgery, depending on availability and the center’s practice), or medical therapy may be considered, as appropriate. If a mild elevation in serum cortisol or UFC is accompanied by either no changes or by slight improvements in clinical symptoms, the patient should be further monitored every 2–3 months. If serum cortisol levels then decrease to <2 µg/dL, the patient can be considered to be in remission. If not, treatment options, such as a second surgery, pituitary irradiation, or medical therapy may be considered if appropriate, especially if other symptoms of CD begin to reappear.