Adrenocortical carcinoma physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(40 intermediate revisions by 9 users not shown)
Line 1: Line 1:
__NOTOC__
{{Adrenocortical carcinoma}}
{{Adrenocortical carcinoma}}
{{CMG}}; {{AE}} {{RT}}
{{CMG}}; {{AE}} {{RT}} {{AAM}} {{MAD}}
 
==Overview==
==Overview==
Common physical examination findings of adrenocortical carcinoma include findings of [[Cushing's syndrome]] such as [[hypertension]], [[weakness]], [[gynecomastia]], and [[acne]]. Hyperandrogenic cases may show findings such as [[clitoromegaly]] and [[hirsuitism|hirsutism]]. 
==Physical Examination==
===Appearance of the patient===
===Appearance of the patient===
* Patient may be [[obese]] with a [[moon like face]] - as in [[Cushing's syndrome]]
* [[Moon like face|Moon-like face]]<ref name="pmid26156970">{{cite journal| author=Nieman LK| title=Cushing's syndrome: update on signs, symptoms and biochemical screening. | journal=Eur J Endocrinol | year= 2015 | volume= 173 | issue= 4 | pages= M33-8 | pmid=26156970 | doi=10.1530/EJE-15-0464 | pmc=4553096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26156970  }}</ref>
* Excessive facial hair - as in [[virilization]]
* [[Buffalo hump]]
* Gynecommastia - as in [[feminization]]
* Patients may appear [[Flushing|flushed]] due to the associated increase in [[erythropoietin]] secretion.<ref name="pmid12923403">{{cite journal| author=La Batide-Alanore A, Chatellier G, Plouin PF| title=Diabetes as a marker of pheochromocytoma in hypertensive patients. | journal=J Hypertens | year= 2003 | volume= 21 | issue= 9 | pages= 1703-7 | pmid=12923403 | doi=10.1097/01.hjh.0000084729.53355.ce | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12923403  }}</ref>
* Patients may appear [[obese]] due to associated type 2 [[diabetes mellitus]] and [[Cushing's syndrome]].<ref name="pmid7567437">{{cite journal| author=Drénou B, Le Tulzo Y, Caulet-Maugendre S, Le Guerrier A, Leclercq C, Guilhem I et al.| title=Pheochromocytoma and secondary erythrocytosis: role of tumour erythropoietin secretion. | journal=Nouv Rev Fr Hematol | year= 1995 | volume= 37 | issue= 3 | pages= 197-9 | pmid=7567437 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7567437  }}</ref>
===Vitals===
* [[Hypotension]] occurs due to fluid contraction
* [[Hypertension|Hypertension due to]] [[Cortisol|cortisol's]] enhancement of [[epinephrine]]'s [[vasoconstrictive]] effect
* [[Tachypnea]] if [[malignant]] secondaries are found in the [[lung]]
* [[Dyspnea]] occurs in patients with complicated [[heart failure]] and [[cardiomyopathy]]


===Chest===
* [[Gynecomastia]]
===Skin===
===Skin===
* Purple striae can be seen on the skin of the abdomen in Cushing's syndrome.
* The [[skin]] may be fragile and thin <ref name="pmid261569702">{{cite journal| author=Nieman LK| title=Cushing's syndrome: update on signs, symptoms and biochemical screening. | journal=Eur J Endocrinol | year= 2015 | volume= 173 | issue= 4 | pages= M33-8 | pmid=26156970 | doi=10.1530/EJE-15-0464 | pmc=4553096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26156970  }}</ref>
* Delayed wound healing
* [[Jaundice]] secondary to deranged [[liver]] function in case of [[metastasis]] to the [[liver]]
* Discoloration
* [[Hyperpigmentation]] - this is due to [[melanocyte-stimulating hormone]] production as a byproduct of [[Adrenocorticotropic hormone|ACTH]] synthesis from [[Proopiomelanocortin|Proopiomelanocortin (POMC)]]
* [[Acne]]
* [[Telangiectasia]] (dilation of [[capillaries]])
* [[Malar flush]]
* Thinning of the [[skin]] (which causes [[easy bruising]])
* Purple or red [[striae]] (the weight gain in [[Cushing's syndrome|Cushing's]] stretches the skin, which is thin and weakened, causing it to [[hemorrhage|bleed]]) on the [[trunk]], [[buttocks]], arms, legs or [[breasts]], and [[proximal]] [[muscle weakness]]
* [[Hirsutism]]
* [[Dehydration]] caused by [[gastrointestinal]] secretion of fluid and [[Electrolyte|electrolytes]]
 
===Head===
* [[Alopecia|Facial flushing]] <ref name="pmid23285767">{{cite journal| author=Simonenko VB, Makanin MA, Dulin PA, Vasilchenko MI, Lesovik VS| title=[About the signs of malignant pheochromocytoma]. | journal=Klin Med (Mosk) | year= 2012 | volume= 90 | issue= 10 | pages= 64-8 | pmid=23285767 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23285767  }}</ref>
* [[Icterus|Scleral icterus]] in case of [[metastasis]] to the [[liver]]
* [[Moon face|Moon-face]]  is often associated with [[Cushing's syndrome]], also known as [[Cushingoid appearance|Cushingoid facies]] <ref name="pmid261569702" />
* [[Alopecia]]


===Abdomen===
* A palpable [[abdominal mass]] in the lower [[abdominal]] quadrant <ref name="pmid23285767" />
* [[Abdominal guarding|Guarding]] may be present
* [[Hepatomegaly]] if [[malignant]] secondaries found in [[liver]]
* [[flushing]] in [[medullary thyroid cancer]] patients


===Extremities===
* [[Clubbing]]
* [[Cyanosis]]
* [[Pitting edema|Pitting]]/non-pitting [[edema]] of the upper/lower [[extremities]] <ref name="pmid12074769">{{cite journal| author=Brunaud L, Duh QY| title=Aldosteronoma. | journal=Curr Treat Options Oncol | year= 2002 | volume= 3 | issue= 4 | pages= 327-33 | pmid=12074769 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12074769  }}</ref>
* [[Muscle atrophy]]
* [[Fasciculations]] in the upper/lower extremity


===Head===
===Neurologic===
* [[Confusion]]
===Genitals===
*[[Clitoromegaly]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}
 
[[Category:Endocrinology]]
 
[[Category:Types of cancer]]
 
[[Category:Disease]]
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 19:00, 30 October 2017

Adrenocortical carcinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Adrenocortical carcinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

MRI

CT

Ultrasound

Other Imaging Studies

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Radiation Therapy

Primary prevention

Secondary prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Study

Case #1

Adrenocortical carcinoma physical examination On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Adrenocortical carcinoma 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 Adrenocortical carcinoma physical examination

CDC on Adrenocortical carcinoma physical examination

Adrenocortical carcinoma physical examination in the news

Blogs on Adrenocortical carcinoma physical examination

Hospitals Treating Adrenocortical carcinoma

Risk calculators and risk factors for Adrenocortical carcinoma physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Ahmad Al Maradni, M.D. [3] Mohammed Abdelwahed M.D[4]

Overview

Common physical examination findings of adrenocortical carcinoma include findings of Cushing's syndrome such as hypertension, weakness, gynecomastia, and acne. Hyperandrogenic cases may show findings such as clitoromegaly and hirsutism. 

Physical Examination

Appearance of the patient

Vitals

Chest

Skin

Head

Abdomen

Extremities

Neurologic

Genitals

References

  1. ↑ Nieman LK (2015). "Cushing's syndrome: update on signs, symptoms and biochemical screening". Eur J Endocrinol. 173 (4): M33–8. doi:10.1530/EJE-15-0464. PMC 4553096. PMID 26156970.
  2. ↑ La Batide-Alanore A, Chatellier G, Plouin PF (2003). "Diabetes as a marker of pheochromocytoma in hypertensive patients". J Hypertens. 21 (9): 1703–7. doi:10.1097/01.hjh.0000084729.53355.ce. PMID 12923403.
  3. ↑ Drénou B, Le Tulzo Y, Caulet-Maugendre S, Le Guerrier A, Leclercq C, Guilhem I; et al. (1995). "Pheochromocytoma and secondary erythrocytosis: role of tumour erythropoietin secretion". Nouv Rev Fr Hematol. 37 (3): 197–9. PMID 7567437.
  4. ↑ 4.0 4.1 Nieman LK (2015). "Cushing's syndrome: update on signs, symptoms and biochemical screening". Eur J Endocrinol. 173 (4): M33–8. doi:10.1530/EJE-15-0464. PMC 4553096. PMID 26156970.
  5. ↑ 5.0 5.1 Simonenko VB, Makanin MA, Dulin PA, Vasilchenko MI, Lesovik VS (2012). "[About the signs of malignant pheochromocytoma]". Klin Med (Mosk). 90 (10): 64–8. PMID 23285767.
  6. ↑ Brunaud L, Duh QY (2002). "Aldosteronoma". Curr Treat Options Oncol. 3 (4): 327–33. PMID 12074769.

Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Adrenocortical_carcinoma_physical_examination&oldid=1381659"