Mitotan is primarily used in the treatment of adrenocortical carcinoma, a rare cancer affecting the adrenal cortex. It works by inhibiting the production of hormones in the adrenal glands and directly damaging adrenal cells, helping to control the symptoms and progression of the disease. Additionally, it is sometimes employed in managing Cushing's syndrome, particularly when caused by adrenal tumors, by reducing excessive cortisol levels. Mitotan is often administered when surgery is not an option or as an adjunct therapy post-surgery to prevent recurrence. Its use requires careful monitoring due to potential side effects and the need for dosage adjustments based on individual response.