Liver mass physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Physical examination findings of liver mass will depend on location and size of the tumor. Usually large liver tumors may cause pain and tenderness in palpation of the abdomen due to stretching of the liver capsule. On the other hand, liver masses with smaller size can present with no remarkable findings. Common physical examination of patients with liver mass, may include: janudice, hepatomegaly, abdominal tenderness, splenomegaly, abdominal wall vascular collaterals, and weight loss.

Physical Examination

• The following physical examination findings may be present among patients with liver mass:

General appearance

• Well-appearing
• Lethargic
• Cachectic
• Confused

Vital Signs

• Decreased SPO2
• Tachypnea
• Tachycardia
• High-grade fever
• Low-grade fever

Chest

Inspection

• Chest alopecia
• Rapid rate of breathing

Auscultation

• Decreased/absent breath sounds

Percussion

• Dull percussion
• Reduced chest expansion

Abdomen

Inspection

• Hepatomegaly
• Splenomegaly

Auscultation

• Cruveilhier-Baumgarten murmur

• Described as a venous hum in patients with portal hypertension
• Present in patients with cirrhosis

Percussion

• Dull percussion

Palpation

• Abdominal distention

Musculoskeletal

• Peripheral edema
• Muscle rigidity
• Hypertrophic osteoarthropathy

Skin

Inspection

• Pallor
• Jaundice
• Plantar and Palmar erythema
• Dermatographic urticaria, or "scratching marks"
• Nail changes

• Muehrcke nails
• Terry nails

HEENT

• Lymphadenopathy

CNS

• Confusion
• Asterixis

Extremities

• Clubbing of fingers
• Swelling of hands and feet
• Weakness
• Absent pulse

References

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