skip to main content

Adrenal incidentaloma — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

HardAdrenalAdrenal incidentalomaSCE Endocrinology

Eighteen months after R0 resection of an adrenocortical carcinoma, surveillance shows a solitary 2 cm liver metastasis. Staging excludes other disease and an expert hepatobiliary team considers complete resection feasible. What is the preferred strategy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Offer complete local treatment and start mitotane after the intervention

Explanation lettering: D = shown as A · A = shown as B · B = shown as D

D is correct. A recurrence-free interval of at least 12 months and a solitary lesion amenable to complete resection define a selected setting in which surgery or another definitive local ablative treatment should be offered, followed by mitotane. EDP-mitotane is favoured when recurrence is early, rapidly progressive or not completely treatable locally; it does not automatically displace a potentially complete intervention after an 18-month interval. Observation, isolated radiotherapy without an ablative plan, and adrenal-bed surgery do not address the documented liver metastasis.

Reference: https://academic.oup.com/ejendo/article/179/4/G1/6655445