Review Question - QID 210564

A 45-year-old man presents to his primary care physician for a wellness checkup. He states that he feels fatigued at times but feels near his baseline. The patient smokes 1 pack of cigarettes per day, drinks alcohol occasionally, and has a past medical history of poorly controlled diabetes. His temperature is 98.6°F (37.0°C), blood pressure is 167/108 mmHg, pulse is 80/min, respirations are 10/min, and oxygen saturation is 98% on room air. A physical exam reveals an overweight man with a ruddy complexion. Bilateral gynecomastia is noted for which the patient inquires about cosmetic surgery as a treatment. Laboratory values are ordered as seen below.

Hemoglobin: 14 g/dL
Hematocrit: 42%
Leukocyte count: 6,500/mm^3 with normal differential
Platelet count: 185,000/mm^3

Serum:
Na+: 142 mEq/L
Cl-: 102 mEq/L
K+: 3.2 mEq/L
HCO3-: 31 mEq/L
BUN: 27 mg/dL
Glucose: 173 mg/dL
Creatinine: 1.5 mg/dL
Ca2+: 9.8 mg/dL

A CT scan demonstrates bilateral abnormal abdominal masses. Which of the following is the most appropriate next step in management?