Adrenocortical carcinoma physical examination: Difference between revisions
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{{CMG}} {{AE}} {{RT}} {{AAM}} | {{CMG}} {{AE}} {{RT}} {{AAM}} | ||
==Overview== | ==Overview== | ||
Common physical examination findings of Adrenocortical carcinoma include | Common physical examination findings of Adrenocortical carcinoma include [[hypertension]], [[weakness]], gynecomastia, and [[acne]]. | ||
==Physical Examination== | ==Physical Examination== | ||
===Appearance of the patient=== | ===Appearance of the patient=== | ||
* [[Moon like face]] | * [[Moon like face|Moon-like face]] | ||
* [[Buffalo hump]] | * [[Buffalo hump]] | ||
* Patients may appear [[Flushing|flushed]] due to the associated increase in [[erythropoietin]] secretion.<sup>[[Incidentaloma physical examination#cite note-pmid7567437-2|[2]]]</sup> | |||
* Patients may appear [[obese]] due to associated type2 [[diabetes mellitus]] and [[Cushing's syndrome]].<sup>[[Incidentaloma physical examination#cite note-pmid12923403-3|[3]]]</sup> | |||
===Vitals=== | ===Vitals=== | ||
* [[Hypertension]] | * [[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=== | ===Chest=== | ||
* Gynecomastia | * Gynecomastia | ||
===Skin=== | ===Skin=== | ||
* Skin may be fragile and thin | * Skin may be fragile and thin | ||
* [[Jaundice]] secondary to deranged [[liver]] function in case of [[metastasis]] to the [[liver]]. | |||
* [[Hyperpigmentation]] - this is due to Melanocyte-Stimulating Hormone production as a byproduct of ACTH synthesis from [[Proopiomelanocortin|Proopiomelanocortin (POMC)]] | |||
* [[Telangiectasia]] (dilation of capillaries) | |||
* Thinning of the skin (which causes [[easy bruising]]) | |||
* Purple or red [[striae]] (the weight gain in Cushing's stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders) | |||
* [[Hirsutism]] (facial male-pattern hair growth) | |||
===Head=== | ===Head=== | ||
* [[Alopecia|Facial flushing]] | |||
* [[Icterus|Scleral icterus]] in case of [[metastasis]] to the [[liver]] | |||
* [[Moon face|Moon-face]] is a medical sign where the face swells up into a rounded shape. It is often associated with [[Cushing's syndrome]], which has led to it being known as Cushingoid facies ("Cushings-like face"), or [[steroid]] treatment, which has led to the name steroid facies. | |||
* [[Alopecia]] | * [[Alopecia]] | ||
===Abdomen=== | ===Abdomen=== | ||
* Abdominal | * A palpable [[abdominal mass]] in the lower [[abdominal]] quadrant. | ||
* | * [[Abdominal guarding|Guarding]] may be present. | ||
* [[Hepatomegaly]] if [[malignant]] secondaries found in [[liver]]. | |||
* [[Diarrhea]] caused by [[gastrointestinal]] secretion of fluid and [[Electrolyte|electrolytes]], and [[flushing]] in [[medullary thyroid cancer]] patients. | |||
===Extremities=== | ===Extremities=== | ||
* [[ | * [[Clubbing]] | ||
* Muscle | * [[Cyanosis]] | ||
* Pitting/non-pitting [[edema]] of the upper/lower extremities | |||
* [[Muscle atrophy]] | |||
* [[Fasciculations]] in the upper/lower extremity | |||
===Neurologic=== | ===Neurologic=== | ||
* [[Confusion]] | * [[Confusion]] | ||
=== | ===Genitals=== | ||
*[[Clitoromegaly]] | *[[Clitoromegaly]] | ||
Revision as of 15:42, 18 September 2017
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Adrenocortical carcinoma Microchapters |
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Differentiating Adrenocortical carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Study |
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Adrenocortical carcinoma physical examination On the Web |
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American Roentgen Ray Society Images of Adrenocortical carcinoma physical examination |
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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]
Overview
Common physical examination findings of Adrenocortical carcinoma include hypertension, weakness, gynecomastia, and acne.
Physical Examination
Appearance of the patient
- Moon-like face
- Buffalo hump
- Patients may appear flushed due to the associated increase in erythropoietin secretion.[2]
- Patients may appear obese due to associated type2 diabetes mellitus and Cushing's syndrome.[3]
Vitals
- Hypotension occurs due to fluid contraction
- Hypertension due to 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 may be fragile and thin
- Jaundice secondary to deranged liver function in case of metastasis to the liver.
- Hyperpigmentation - this is due to Melanocyte-Stimulating Hormone production as a byproduct of ACTH synthesis from Proopiomelanocortin (POMC)
- Telangiectasia (dilation of capillaries)
- Thinning of the skin (which causes easy bruising)
- Purple or red striae (the weight gain in Cushing's stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders)
- Hirsutism (facial male-pattern hair growth)
Head
- Facial flushing
- Scleral icterus in case of metastasis to the liver
- Moon-face is a medical sign where the face swells up into a rounded shape. It is often associated with Cushing's syndrome, which has led to it being known as Cushingoid facies ("Cushings-like face"), or steroid treatment, which has led to the name steroid facies.
- Alopecia
Abdomen
- A palpable abdominal mass in the lower abdominal quadrant.
- Guarding may be present.
- Hepatomegaly if malignant secondaries found in liver.
- Diarrhea caused by gastrointestinal secretion of fluid and electrolytes, and flushing in medullary thyroid cancer patients.
Extremities
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity