The surgeon did her job regarding the adrenal removal. Agree.
But even with my consultation with her, I bring up the problematic adrenal and the possibility of it being a pheochromocytoma.
She says "For that, I would have to see a scan about 10 years before to see if there's any growth."
To which I responded, "You mean like my PET scan from 2008 of the same region mentioned in the first paragraph of your report?"
She barely read my report.
Sloppiness.
Parallels with the software industry - I think doctors could benefit from being paired with a complimentary doctor to act as a team and to check each other's work.
I think they simultaneously have a god complex for which their assessments are rarely checked. They need social pressure to probe further.
Would it had mattered prior to surgery if it was a different type of tumor (and rare at that)? Otherwise, I could see why that isn't a discussion worth having anyway.
"Representative sections predominantly consist of a normal adrenal gland with intermixed adrenocortical tissue and medulla. A distinct nodular area is present with prominent foamy-type clear cytoplasm reminiscent of normal adrenocortical tissue. No significant cytologic atypia, necrosis, or increased mitotic activity is present. These findings are consistent with an adrenocortical adenoma. Note: this area appears to be limited to the adrenal gland although some adrenocortical tissue is present in the adipose tissue outside the capsule that morphologically appears dissimilar to the nodule and likely represents normal/benign tissue. Clinical correlation recommended."
Tough case. Adrenal adenomas are common incidental findings. ~15% are hormonally active, which means the vast majority are not.
As a radiologist, I sometimes wonder about whether I make too many recommendations to referring doctors (consider endocrine evaluation for a potentially hormonally active adrenal nodule).
A FREQUENT attack on us as a specialty is that we "find too many incidentals" (see attacks on mammography, breast cancer screening, other sorts of screening, ad nauseam).
Perhaps I'll keep doing the adrenal nodule recommendation, although I usually only make the recommendation if it's 1cm or larger.
Sometimes we have the clinical context, usually if practicing in a large hospital system with an integrated EMR. It's not usually so neatly summarized though; maybe if we are lucky we can quickly glance through relevant notes at the time of scan interpretation.
However, healthcare in the US is very fragmented. Many patients seek cheaper imaging at freestanding imaging centers. Those places often don't have the same HIT integrations to have similar medical context.
And in those settings, I only know what's on the images and maybe 200-300 characters on the "reason for study" box.
This is not to say I think everyone should get scanned at expensive sites; more an indictment on how annoying the current EMR situation is.
Btw., you still needed someone to remove your gland, I take it, so at that point someone else actually did their job, no?