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Subungual Melanoma — SCE Medical Oncology MCQ

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HardMelanoma & SkinSubungual MelanomaSCE Medical Oncology

A solitary adrenal lesion appears during follow-up of resected lung cancer. It is not conclusively benign on dedicated imaging, and resection would be considered if it is the only metastasis. Before percutaneous biopsy, which set of conditions is required?

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Correct answer: B — Exclude phaeochromocytoma; biopsy only if hormonally inactive, imaging-indeterminate and histology changes care

ESE guidance restricts adrenal biopsy in a patient with extra-adrenal malignancy to lesions that are hormonally inactive, not conclusively benign on imaging, and where histology would alter management. Phaeochromocytoma must be excluded before needle biopsy because of catecholamine-crisis risk.

Reference: European Society of Endocrinology 2023 adrenal incidentaloma guideline. https://www.ese-hormones.org/publications/directory/ese-clinical-practice-guideline-on-the-management-of-adrenal-incidentalomas-in-collaboration-with-the-european-network-for-the-study-of-adrenal-tumors/