A 52-year-old man with a 10-year history of hypertension presents to the emergency department with a 2-hour history of sudden-onset severe occipital headache, diaphoresis, and tremor. His wife reports he has been increasingly anxious over the past month. Vital signs: BP 215/125 mmHg, HR 122/min, RR 22/min, temperature 37.1°C. Physical examination is notable for diaphoresis and mild tremor but no focal neurologic deficits. A stat non-contrast head CT is normal. Laboratory studies show serum glucose 278 mg/dL and serum creatinine 1.2 mg/dL. Twenty-four-hour urine metanephrines are elevated at 2.9 nmol/L (normal <0.9 nmol/L). Abdominal CT with contrast reveals a 3.2-cm right adrenal mass with homogeneous enhancement and no imaging features concerning for malignancy. Which of the following is the most appropriate next step in management?

1. A)Proceed directly to right adrenalectomy after acute blood pressure stabilization
2. B)Initiate intravenous nicardipine for hypertensive emergency, then obtain plasma free metanephrines before further intervention
3. C)Start phenoxybenzamine for alpha-blockade, then add a beta-blocker after adequate alpha-blockade is achievedGABARITO
4. D)Administer intravenous labetalol to rapidly reduce blood pressure, then schedule adrenalectomy within 24 hours
5. E)Perform fine-needle aspiration biopsy of the adrenal mass to confirm pheochromocytoma before surgical planning