Leiomyosarcoma physical examination: Difference between revisions

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== Overview ==
== Overview ==
Patients with Leiomyosarcoma generally appear weak.Physical examination findings depends upon the site of the involvement,size and metastasis.Physical Examination findings may include weight loss, abdominal mass, Distension,Ascites, rectal bleeding and vaginal bleeding.
Patients with Leiomyosarcoma generally appear weak. Physical examination findings depends upon the site of the involvement,size and metastasis.Physical Examination findings may include weight loss, abdominal mass, Distension,Ascites, rectal bleeding and vaginal bleeding.


== Physical Examination ==
== Physical Examination ==
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=== Lungs ===
=== Lungs ===
* [[Dyspnea]] and [[chest pain]] in case of Leiomyosarcoma of the Pulmonary artery<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>
* [[Dyspnea]] and [[chest pain]] in case of leiomyosarcoma of the pulmonary artery<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>


=== Abdomen ===
=== Abdomen ===
* Non tender Abdominal mass
* Non tender Abdominal mass
* Abdominal distension,hepatomegaly and ascites in case of Leiomyosarcoma of the inferior vena cava<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>
* Abdominal distension,hepatomegaly and ascites in case of leiomyosarcoma of the inferior vena cava<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>


=== '''Rectum''' ===
=== '''Rectum''' ===
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=== Genitourinary ===
=== Genitourinary ===
* [[Vaginal bleeding]] and discharge in case of uterine Leiomyosarcoma.
* [[Vaginal bleeding]] and discharge in case of uterine leiomyosarcoma.


=== Extremities ===
=== Extremities ===
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=== Paraneoplasic Syndrome manifestations ===
=== Paraneoplasic Syndrome manifestations ===
Rarely, Leiomyosarcoma presents with paraneoplastic hypoglycemia, which is usually secondary to the tumour production of insulin like growth factor-2<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>
Rarely, leiomyosarcoma presents with paraneoplastic hypoglycemia, which is usually secondary to the tumour production of insulin like growth factor-2<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>


==References==
==References==

Revision as of 20:35, 5 March 2019

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Overview

Patients with Leiomyosarcoma generally appear weak. Physical examination findings depends upon the site of the involvement,size and metastasis.Physical Examination findings may include weight loss, abdominal mass, Distension,Ascites, rectal bleeding and vaginal bleeding.

Physical Examination

Physical examination findings depends upon the site of the involvement,size and metastasis.

Appearance of the Patient

  • Patients with Leiomyosarcoma are generally weak due to weight loss.

Vital Signs

Skin

  • Jaundice may appear if the tumor develops in the inferior vena cava in the supra-hepatic segment or metastasis to pancreas. [1]

Neck

  • Lymphadenopathy

Lungs

Abdomen

  • Non tender Abdominal mass
  • Abdominal distension,hepatomegaly and ascites in case of leiomyosarcoma of the inferior vena cava[3]

Rectum

  • Blood on rectal Examination[4]

Genitourinary

Extremities

Lower extremity edema if the tumors that arise in the inferior vena cava below the liver[5]

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[6]

References

  1. 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.
  2. 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
  3. 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
  4. 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
  5. 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
  6. Strauss G, Christensen L, Zapf J (1994) Tumour-induced hypoglycaemia due to 'big' IGF-II. J Intern Med 236 (1):97-9. PMID: 8021581


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