General Surgery

Answer 5 Surgical resection. This patient has an incidentaloma that is suspicious for adrenalcortical cancer. Surgical resection with complete excision should be undertaken to establish a diagnosis and enhance survival. Observation is an acceptable choice for smaller masses but not for this large tumor. FNA is indicated for suspected metastatic tumors. The incidentaloma cannot be treated without establishing a diagnosis, and even if the diagnosis of adrenocortical cancer is confirmed, chemotherapy and radiation have limited success in treating these aggressive tumors. SUGGESTED READINGS 1. Cameron JL, editor. Current surgical therapy. 8th ed. Philadelphia: Elsevier Mosby; 2004. 2. Townsend CM, Beauchamp RD, Evers BM, et al. Sabiston textbook of surgery: the biological basis of modern surgical practice. 17th ed. Philadelphia: Saunders; 2004. Click here to return to the questions

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