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Today's patient is a 55-year-old man from Miami. Over the previous months he had noticed gynecomastia (breast tissue developing in a man), tiredness, and decreased libido (sex drive). He had actually seen a surgeon to have his breast tissue removed (never performed, fortunately), but via a circuitous route was referred to an endocrinologist. This doctor understood what was going on and ordered laboratory test and an MRI scan of his abdomen. The laboratory test showed very high cortisol levels (Cushing’s syndrome, causing his fatigue) and high estrogen levels (leading to feminization causing breast development and decreased sex drive). The MRI demonstrated a huge left adrenal mass. Read more about symptoms of adrenal cancer here: https://www.adrenal.com/blog/top-symp... The patient had seen a number of surgeons and been recommended everything from biopsies to radiation and chemotherapy. What this patient needed was an operation. Read why adrenal biopsy are a huge mistake in almost all patients here: https://www.adrenal.com/adrenal-gland... Chemotherapy should never be used unless surgery is no longer an option. Read about stage 4 (unresectable) adrenal cancer here: https://www.adrenal.com/blog/why-is-i... Luckily, this patient found us and came in for surgery. He is doing tremendously well! 00:02 Introduction to adrenal cortical carcinoma case 00:41 Imaging and surgical approach details 01:16 Postoperative outcomes and follow-up