Stomach cancer physical examination

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]

Stomach cancer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Stomach Cancer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Endoscopy and Biopsy
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Stomach cancer physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Stomach cancer physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Stomach cancer physical examination
CDC on Stomach cancer physical examination
Stomach cancer physical examination in the news
Blogs on Stomach cancer physical examination
Directions to Hospitals Treating Stomach cancer
Risk calculators and risk factors for Stomach cancer physical examination

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]