Leiomyosarcoma physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Leiomyosarcoma}} | {{Leiomyosarcoma}} | ||
{{CMG}};{{AE}} | |||
== Overview == | == Overview == | ||
Patients with | Patients with leiomyosarcoma mostly have no symptoms and signs of disease, other than irregular [[vaginal bleeding]] or growing [[mass]] protruding into vagina. Physical examination findings depends upon the site of the involvement, size of tumor and [[metastasis]]. Physical examination findings may include [[weight loss]], [[abdominal mass]], [[abdominal distension]], [[vaginal bleeding]] or [[discharge]]. | ||
== Physical Examination == | == Physical Examination == | ||
Physical examination findings depends upon the site of the involvement,size and metastasis. | Physical examination findings depends upon the site of the involvement,size and metastasis.<ref name="IwamotoFujino2005">{{cite journal|last1=Iwamoto|first1=Ichiro|last2=Fujino|first2=Toshinori|last3=Higashi|first3=Yohichi|last4=Tsuji|first4=Takahiro|last5=Nakamura|first5=Noboru|last6=Komokata|first6=Teruo|last7=Douchi|first7=Tsutomu|title=Metastasis of uterine leiomyosarcoma to the pancreas|journal=Journal of Obstetrics and Gynaecology Research|volume=31|issue=6|year=2005|pages=531–534|issn=1341-8076|doi=10.1111/j.1447-0756.2005.00344.x}}</ref><ref name="pmid11675204">Hoffmeier A, Semik M, Fallenberg EM, Scheld HH (2001) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11675204 Leiomyosarcoma of the pulmonary artery--a diagnostic chameleon.] ''Eur J Cardiothorac Surg'' 20 (5):1049-51. PMID: [https://pubmed.gov/11675204 11675204]</ref><ref name="pmid28631648">Nambiyar K, Ahuja A, Bhardwaj M (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28631648 Leiomyosarcoma of inferior vena cava with intracardiac extension presenting as Budd-Chiari syndrome: Report of a rare case.] ''Indian J Pathol Microbiol'' 60 (2):256-258. [http://dx.doi.org/10.4103/IJPM.IJPM_782_15 DOI:10.4103/IJPM.IJPM_782_15] PMID: [https://pubmed.gov/28631648 28631648]</ref><ref name="pmid27530097">Jideh B, Yang T, Turner I (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=27530097 Rectal Bleeding Due to Leiomyosarcoma.] ''Clin Gastroenterol Hepatol'' 15 (1):e1-e2. [http://dx.doi.org/10.1016/j.cgh.2016.08.008 DOI:10.1016/j.cgh.2016.08.008] PMID: [https://pubmed.gov/27530097 27530097]</ref><ref name="pmid29131350">Nabati M, Azizi S (2018) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=29131350 Leiomyosarcoma of the inferior vena cava presenting as a cardiac mass.] ''J Clin Ultrasound'' 46 (6):430-433. [http://dx.doi.org/10.1002/jcu.22558 DOI:10.1002/jcu.22558] PMID: [https://pubmed.gov/29131350 29131350]</ref><ref name="pmid8021581">Strauss G, Christensen L, Zapf J (1994) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8021581 Tumour-induced hypoglycaemia due to 'big' IGF-II.] ''J Intern Med'' 236 (1):97-9. PMID: [https://pubmed.gov/8021581 8021581]</ref><ref name="urlSoft Tissue Sarcoma - NORD (National Organization for Rare Disorders)">{{cite web |url=https://rarediseases.org/rare-diseases/soft-tissue-sarcoma/ |title=Soft Tissue Sarcoma - NORD (National Organization for Rare Disorders) |format= |work= |accessdate=}}</ref> | ||
=== Appearance of the Patient === | === Appearance of the Patient === | ||
* Patients with | * Patients with leiomyosarcoma are generally weak due to [[weight loss]]. | ||
=== Vital Signs === | === Vital Signs === | ||
* Low | * Low grade [[fever]] | ||
=== Skin === | === Skin === | ||
* [[Jaundice]] may appear if the tumor develops in the inferior vena cava in the supra-hepatic segment | * [[Jaundice]] may appear if the tumor develops in the [[inferior vena cava]] in the supra-hepatic segment or [[metastasis]] to [[pancreas]]. | ||
* Pallor | |||
* [[Pallor]] | |||
=== Neck === | === Neck === | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
=== Lungs === | === Lungs === | ||
* Dyspnea and chest pain in case of | * [[Dyspnea]] and [[chest pain]] in case of leiomyosarcoma of the [[pulmonary artery]]. | ||
=== Abdomen === | === Abdomen === | ||
* Non tender | * Non tender [[abdominal mass]] | ||
* Abdominal distension,hepatomegaly and ascites in case of | * [[Abdominal distension]], [[hepatomegaly]] and [[ascites]] in case of leiomyosarcoma of the [[inferior vena cava]]. | ||
=== '''Rectum''' === | === '''Rectum''' === | ||
* Blood on rectal | * [[Blood]] on [[rectal examination]]. | ||
=== Genitourinary === | === Genitourinary === | ||
* Vaginal bleeding and discharge in case of uterine | * [[Vaginal bleeding]] and [[discharge]] in case of uterine leiomyosarcoma. | ||
=== Extremities === | === Extremities === | ||
Lower extremity edema if the tumors that arise in the inferior vena cava below the liver | * [[Lower extremity]] [[edema]] if the tumors that arise in the [[inferior vena cava]] below the liver. | ||
=== Neuromuscular === | === Neuromuscular === | ||
* | * [[Paresthesia]] due to the compression of the [[neurovascular bundle]] by the enlarging [[mass]] | ||
=== Paraneoplasic Syndrome manifestations === | === Paraneoplasic Syndrome manifestations === | ||
Rarely, | * Rarely, leiomyosarcoma presents with [[paraneoplastic]] [[hypoglycemia]], which is usually secondary to the [[tumour]] production of [[IGF|insulin like growth factor]]-2 | ||
==References== | ==References== | ||
Latest revision as of 16:48, 2 April 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief:
Overview
Patients with leiomyosarcoma mostly have no symptoms and signs of disease, other than irregular vaginal bleeding or growing mass protruding into vagina. Physical examination findings depends upon the site of the involvement, size of tumor and metastasis. Physical examination findings may include weight loss, abdominal mass, abdominal distension, vaginal bleeding or discharge.
Physical Examination
Physical examination findings depends upon the site of the involvement,size and metastasis.[1][2][3][4][5][6][7]
Appearance of the Patient
- Patients with leiomyosarcoma are generally weak due to weight loss.
Vital Signs
- Low grade fever
Skin
- Jaundice may appear if the tumor develops in the inferior vena cava in the supra-hepatic segment or metastasis to pancreas.
Neck
Lungs
- Dyspnea and chest pain in case of leiomyosarcoma of the pulmonary artery.
Abdomen
- Non tender abdominal mass
- Abdominal distension, hepatomegaly and ascites in case of leiomyosarcoma of the inferior vena cava.
Rectum
Genitourinary
- Vaginal bleeding and discharge in case of uterine leiomyosarcoma.
Extremities
- Lower extremity edema if the tumors that arise in the inferior vena cava below the liver.
Neuromuscular
- Paresthesia due to the compression of the neurovascular bundle by the enlarging mass
Paraneoplasic Syndrome manifestations
- Rarely, leiomyosarcoma presents with paraneoplastic hypoglycemia, which is usually secondary to the tumour production of insulin like growth factor-2
References
- ↑ Iwamoto, Ichiro; Fujino, Toshinori; Higashi, Yohichi; Tsuji, Takahiro; Nakamura, Noboru; Komokata, Teruo; Douchi, Tsutomu (2005). "Metastasis of uterine leiomyosarcoma to the pancreas". Journal of Obstetrics and Gynaecology Research. 31 (6): 531–534. doi:10.1111/j.1447-0756.2005.00344.x. ISSN 1341-8076.
- ↑ Hoffmeier A, Semik M, Fallenberg EM, Scheld HH (2001) Leiomyosarcoma of the pulmonary artery--a diagnostic chameleon. Eur J Cardiothorac Surg 20 (5):1049-51. PMID: 11675204
- ↑ Nambiyar K, Ahuja A, Bhardwaj M (2017) Leiomyosarcoma of inferior vena cava with intracardiac extension presenting as Budd-Chiari syndrome: Report of a rare case. Indian J Pathol Microbiol 60 (2):256-258. DOI:10.4103/IJPM.IJPM_782_15 PMID: 28631648
- ↑ Jideh B, Yang T, Turner I (2017) Rectal Bleeding Due to Leiomyosarcoma. Clin Gastroenterol Hepatol 15 (1):e1-e2. DOI:10.1016/j.cgh.2016.08.008 PMID: 27530097
- ↑ Nabati M, Azizi S (2018) Leiomyosarcoma of the inferior vena cava presenting as a cardiac mass. J Clin Ultrasound 46 (6):430-433. DOI:10.1002/jcu.22558 PMID: 29131350
- ↑ Strauss G, Christensen L, Zapf J (1994) Tumour-induced hypoglycaemia due to 'big' IGF-II. J Intern Med 236 (1):97-9. PMID: 8021581
- ↑ "Soft Tissue Sarcoma - NORD (National Organization for Rare Disorders)".