Hereditary nonpolyposis colorectal cancer 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

Patients with hereditary nonpolyposis colorectal cancer are usually young and have a family history of colorectal cancer. Physical examination of patients with Lynch syndrome may show the presence of the fordyce granules.

Physical Examination

The majority of patients are asymptomatic until they present with early onset symptoms such as gastrointestinal bleeding, abdominal pain, or a change in bowel habits.

General appearance

Lethargic
Pale
Emaciated
Confused

Vital Signs

Vital signs are generally within normal limit, but patients with severe disease may have the following vital signs:

Low-grade fever
Decreased SPO2
Tachyapnea
Tachycardia
Low BP

Abdomen

Discomfort on palpation
Hepatomegaly
Absent bowel sounds - may be suggested of intestinal obstruction
Ascites

Chest

Decreased/absent breath sounds

Skin

Pallor
Fordyce granules (FGs): Oral ectopic sebaceous glands and alteration in vascular patterns in the oral mucosa.

HEENT

Extremities

Swelling of hands and feet

Gallery

Extraoral photograph image showing Fordyce granules in the upper lip (arrows) of individual III:5 with hereditary nonpolyposis colorectal cancer and colorectal cancer.Creative Commons BY-SA-NC^[1]

References

↑ Almeida FT, Gomes RR, Leite AF, Sousa JB, Acevedo AC, Guerra EN. Oral manifestations of hereditary nonpolyposis colorectal cancer syndrome: a family case series. J Med Case Rep. 2014;8:249.

Template:WikiDoc Sources

[creativecommons-1] Almeida FT, Gomes RR, Leite AF, Sousa JB, Acevedo AC, Guerra EN. Oral manifestations of hereditary nonpolyposis colorectal cancer syndrome: a family case series. J Med Case Rep. 2014;8:249.

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