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NSCLC staging with adrenal lesion — SCE Respiratory MCQ

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HardLung CancerNSCLC staging with adrenal lesionSCE Respiratory

A 68-year-old man with lung adenocarcinoma has PET-avid ipsilateral mediastinal nodes and a solitary adrenal lesion. The adrenal lesion is also PET-avid. CT-guided biopsy of the lung is positive for adenocarcinoma. What is the most appropriate investigation?

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Correct answer: E — Biopsy of the adrenal lesion if it would alter treatment intent

A solitary PET-avid adrenal lesion in otherwise potentially treatable lung cancer should be sampled if the result changes staging and treatment intent. Proceeding to surgery without clarifying possible metastasis risks inappropriate curative treatment. PET avidity is not specific enough to assume malignancy or benignity without tissue when management hinges on it.

Reference: NICE NG122 Lung cancer