Review Question - QID 219814

A 31-year-old obese male presents with a history of a worsening skin lesion on his abdomen, as shown in Figure A, that appears to be associated with an underlying slow-growing, "nodular" mass that the patient states has been getting bigger over the last 5 years. He says he has gained a significant amount of weight over the same period and is not sure if this is related. A CT scan is obtained with representative images shown in Figures B and C, and a biopsy of the mass shows the histopathology in Figures D and E, with immunohistochemistry demonstrating a t(17,22) mutation. Which of the following represents the best next step in treatment?