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
Answer: D
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