Stomach cancer physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}}{{AE}} {{YD}}; {{PSD}} | {{CMG}}{{AE}} {{YD}}; {{PSD}} | ||
{{Stomach cancer}} | {{Stomach cancer}} | ||
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===Skin=== | ===Skin=== | ||
*[[Pallor]] | *[[Pallor]] | ||
*[[Jaundice]] may appear if hepatic obstruction occurs | *[[Jaundice]] may appear if hepatic obstruction occurs [7] | ||
*[[Acanthosis nigricans]] | *[[Acanthosis nigricans]] [9] velvety and darkly pigmented patches on skin folds. | ||
*[[Leser-Trelat sign]]: acute-onset multiple seborrheic keratosis lesions that are usually located on the patient's back | *[[Leser-Trelat sign]]: acute-onset multiple seborrheic keratosis lesions that are usually located on the patient's back [8 | ||
===Neck=== | ===Neck=== | ||
*[[Virchow's node]]: Left supraclavicular adenopathy | *[[Virchow's node]]: Left supraclavicular adenopathy [3] | ||
===Abdomen=== | ===Abdomen=== | ||
* The presence of a palpable abdominal mass is the most common physical finding [1]. | |||
*[[Abdominal distention]] | *[[Abdominal distention]] | ||
*[[Sister Mary Joseph nodule]]: a visible periumbilical nodule that is highly suggestive of umbilical metastasis | |||
*[[Sister Mary Joseph nodule]]: | |||
*[[Splenomegaly]] | *[[Splenomegaly]] | ||
*[[Ascites]] | *[[Ascites]]: It can be the first indication of peritoneal carcinomatosis | ||
*A palpable liver mass: it is often multifocal or diffuse, usually associated with an elevation in the serum alkaline phosphatase concentration. | |||
===Rectum=== | ===Rectum=== | ||
*Blood on [[rectal exam]] | *Blood on [[rectal exam]] | ||
*Blumer's shelf: Rectal mass/shelf palpable on rectal exam | *Blumer's shelf: Rectal mass/shelf palpable on rectal exam [6] | ||
===Genitourinary=== | ===Genitourinary=== | ||
*Ovarian mass may be suggestive of [[Krukenberg tumor|Krukenberg syndome]] | *Ovarian mass may be suggestive of [[Krukenberg tumor|Krukenberg syndome]] 5 | ||
*[[Trousseau's syndrome]]: Migratory phlebitis commonly associated with visceral malignancy | *[[Trousseau's syndrome]]: Migratory phlebitis commonly associated with visceral malignancy | ||
*[[Muscle weakness]] | *[[Muscle weakness]] | ||
=== '''Paraneoplastic syndrome manifestations''' === | |||
* Microangiopathic hemolytic anemia [10] | |||
* Membranous nephropathy [11] | |||
* Trousseau's syndrome: hypercoagulable states [12] | |||
* Polyarteritis nodosa: [13] | |||
==References== | ==References== | ||
Revision as of 19:45, 6 November 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Parminder Dhingra, M.D. [2]
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Overview
Patients with stomach cancer generally appear healthy. Common physical examination findings include abdominal distention, palpation of an abdominal mass, and pallor. Leser-Trelat sign and presence of Virchow's node (left supraclavicular lymphadenopathy), Sister Mary Joseph nodule (visible periumbilical nodule), Blumer's shelf (rectal mass/shelf on rectal exam) and/or Trousseau's syndrome (migratory phlebitis) on physical examination are highly suggestive of stomach cancer.
Physical Examination
General Appearance
- Patients with gastric cancer are generally well-appearing
- Patients may appear weak in advanced cases
Skin
- Pallor
- Jaundice may appear if hepatic obstruction occurs [7]
- Acanthosis nigricans [9] velvety and darkly pigmented patches on skin folds.
- Leser-Trelat sign: acute-onset multiple seborrheic keratosis lesions that are usually located on the patient's back [8
Neck
- Virchow's node: Left supraclavicular adenopathy [3]
Abdomen
- The presence of a palpable abdominal mass is the most common physical finding [1].
- Abdominal distention
- Sister Mary Joseph nodule: a visible periumbilical nodule that is highly suggestive of umbilical metastasis
- Splenomegaly
- Ascites: It can be the first indication of peritoneal carcinomatosis
- A palpable liver mass: it is often multifocal or diffuse, usually associated with an elevation in the serum alkaline phosphatase concentration.
Rectum
- Blood on rectal exam
- Blumer's shelf: Rectal mass/shelf palpable on rectal exam [6]
Genitourinary
- Ovarian mass may be suggestive of Krukenberg syndome 5
- Trousseau's syndrome: Migratory phlebitis commonly associated with visceral malignancy
- Muscle weakness
Paraneoplastic syndrome manifestations
- Microangiopathic hemolytic anemia [10]
- Membranous nephropathy [11]
- Trousseau's syndrome: hypercoagulable states [12]
- Polyarteritis nodosa: [13]