What is the most appropriate next step in management?

A 48-year-old man presented with gynaecomastia. His serum oestradiol was increased and

a CT scan of adrenal glands revealed a 13-cm tumour of the left adrenal gland. Further workup showed increased secretion of 17-hydroxyprogesterone, cortisol and androstenedione. A diagnosis of adrenocortical carcinoma was suspected.

Investigations:

staging CT scan of chest and abdomenno evidence of metastasis

What is the most appropriate next step in management?
A . adrenal fine-needle biopsy
B . iodocholesterol scan
C . left adrenalectomy followed by adjuvant combination chemotherapy
D . left adrenalectomy followed by adjuvant mitotane treatment
E . MR scan of adrenal glands with chemical shift analysis

View Answer

Answer: D