Liposarcoma physical examination: Difference between revisions

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*The physical examination findings will depend on the location of the liposarcoma, the most common locations are in the extremities or [[retroperitoneal]].
Physical examination findings will depend on the location of the liposarcoma. Most liposarcomas are located in the lower extremities or in the [[retroperitoneum]].
*It is important to search for [[lymph node]] enlargement, as well as the size of the tumor to determine the stage of the disease.
*An entire body examination is mandatory to assess [[lymph node]] involvement and distant [[metastasis]].  
 
====Extremities====
====Extremities====
*The most common location is in the lower extremities, specially in the tight or popliteal region.
*A palpable firm nontender mass may be appreciated on physical examination.  Assessment of the following mass characteristics is crucial during physical examination:
*A painless mass is palpated in the anatomic location of the liposarcoma.
*In the physical examination, is important to assess the following characteristics:
:* Size
:* Size
:* Location
:* Location
Line 24: Line 19:
:* Involvement of adjacent structures (such as peripheral [[nerves]] or [[veins]])
:* Involvement of adjacent structures (such as peripheral [[nerves]] or [[veins]])
:* Edema
:* Edema
====Lymphadenopathy====
*Regional nontender [[lymphadenopathy]] may be a pertinent finding on physical examination that suggests [[lymph]] node involvement, which is important for TNM staging of the disease.
*Whole-body examination for lymphadenopathy is also warranted to evaluate for [[distal metastasis]].


====Abdominal====
====Abdominal====
*The physical examination might be unremarkable in case of [[retroperitoneal]] liposarcomas.  
*The physical examination is usually unremarkable among patients with [[retroperitoneal]] liposarcomas. The development of symptoms may not start until the [[retroperitoneal]] liposarcomas measures up to 10-20 cm
*Most [[retroperitoneal]] liposarcomas can measure up to 20 cm before causing symptoms.
*Other pertinent physical examination findings for [[retroperitoneal]] location include:<ref name="KumarasamyGayer2011">{{cite journal|last1=Kumarasamy|first1=Narmadan A.|last2=Gayer|first2=Gabriela|title=Retroperitoneal Sarcomas|journal=Seminars in Ultrasound, CT and MRI|volume=32|issue=5|year=2011|pages=422–432|issn=08872171|doi=10.1053/j.sult.2011.06.002}}</ref>
*Physical findings for [[retroperitoneal]] location include:<ref name="KumarasamyGayer2011">{{cite journal|last1=Kumarasamy|first1=Narmadan A.|last2=Gayer|first2=Gabriela|title=Retroperitoneal Sarcomas|journal=Seminars in Ultrasound, CT and MRI|volume=32|issue=5|year=2011|pages=422–432|issn=08872171|doi=10.1053/j.sult.2011.06.002}}</ref>
:* Palpable abdominal [[mass]].  Commonly, abdominal liposarcomas are located in the lower quadrants.
:* Palpable [[mass]] in any of the abdominal quadrants (more common in the lower quadrants)
:* Abdominal [[tenderness]]
:* Abdominal [[tenderness]]
:* [[Abdominal distention]]
:* [[Abdominal distention]]

Revision as of 19:03, 23 September 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

Physical examination findings of liposarcoma depend on the location of the tumor. Since most liposarcomas are located in the lower extremities, liposarcoma is commonly associated with the findings of palpable firm nontender mass in one lower extremity. The physical examination findings will depend on the location of the liposarcoma, being the most common location the lower extremities. The main finding is a painless, slow growing, firm mass in one of the lower extremities. Physical examination findings of retroperitoneal liposarcomas include abdominal distension and tenderness.

Physical Examination

Liposarcoma in the right knee. Image courtesy of Wikimedia Commons.
Liposarcoma in the left scapular region. Image courtesy of Wikimedia Commons.

Physical examination findings will depend on the location of the liposarcoma. Most liposarcomas are located in the lower extremities or in the retroperitoneum.

Extremities

  • A palpable firm nontender mass may be appreciated on physical examination. Assessment of the following mass characteristics is crucial during physical examination:
  • Size
  • Location
  • Depth
  • Involvement of adjacent structures (such as peripheral nerves or veins)
  • Edema

Lymphadenopathy

  • Regional nontender lymphadenopathy may be a pertinent finding on physical examination that suggests lymph node involvement, which is important for TNM staging of the disease.
  • Whole-body examination for lymphadenopathy is also warranted to evaluate for distal metastasis.

Abdominal

  • The physical examination is usually unremarkable among patients with retroperitoneal liposarcomas. The development of symptoms may not start until the retroperitoneal liposarcomas measures up to 10-20 cm
  • Other pertinent physical examination findings for retroperitoneal location include:[1]

References

  1. Kumarasamy, Narmadan A.; Gayer, Gabriela (2011). "Retroperitoneal Sarcomas". Seminars in Ultrasound, CT and MRI. 32 (5): 422–432. doi:10.1053/j.sult.2011.06.002. ISSN 0887-2171.


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