
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Stomach cancer physical examination
Introduction
Overview
Overview
Patients with stomach cancer generally appear weak. Common physical examination findings include abdominal distention, palpation of an abdominal mass, and pallor. Leser-Trelat sign and presence of Virchow’s node (left supraclavicular lymphadenopathy), Sister Mary Joseph nodule (visible periumbilical nodule), Blumer’s shelf (rectal mass/shelf on rectal exam) and/or Trousseau’s syndrome (migratory phlebitis) on physical examination are highly suggestive of stomach cancer
Physical Examination
Physical Examination
General Appearance
- Patients with gastric cancer are generally weak due to weight loss.
Skin
- Pallor.
- Jaundice may appear if bile duct obstruction occurs.[1]
- Acanthosis nigricans: Velvety and hyperpigmented patches on skin folds.[2]
- Leser-Trelat sign: Acute-onset multiple seborrheic keratosis lesions that are usually located on the patient’s back.[3]
Neck
Abdomen
- The presence of a palpable abdominal mass is the most common physical finding.[5]
- Abdominal distention.
- Sister Mary Joseph nodule: A visible periumbilical nodule that is highly suggestive of umbilical metastasis.
- Splenomegaly.
- Ascites: It can be the first indication of peritoneal carcinomatosis.
- A palpable liver mass: It is often multifocal or diffuse, usually associated with an elevation in the serum alkaline phosphatase concentration.
Rectum
- Blood on rectal exam.
- Blumer’s shelf: Rectal mass/shelf palpable on rectal exam.[6]
Genitourinary
- Ovarian mass may be suggestive of Krukenberg syndome.[7]
Extremities
Paraneoplastic syndrome manifestationsΒ
References
References
- β Fuchs CS, Mayer RJ (1995). “Gastric carcinoma”. N Engl J Med. 333 (1): 32β41. doi:10.1056/NEJM199507063330107. PMIDΒ 7776992.
- β Muehldorfer SM, Stolte M, Martus P, Hahn EG, Ell C, Multicenter Study Group “Gastric Polyps” (2002). “Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: a prospective multicentre study”. Gut. 50 (4): 465β70. PMCΒ 1773183. PMIDΒ 11889063.
- β Dantzig PI (1973). “Sign of Leser-TrΓ©lat”. Arch Dermatol. 108 (5): 700β1. PMIDΒ 4270762.
- β Morgenstern L (1979). “The Virchow-Troisier node: a historical note”. Am J Surg. 138 (5): 703. PMIDΒ 386813.
- β Wanebo HJ, Kennedy BJ, Chmiel J, Steele G, Winchester D, Osteen R (1993). “Cancer of the stomach. A patient care study by the American College of Surgeons”. Ann Surg. 218 (5): 583β92. PMCΒ 1243028. PMIDΒ 8239772.
- β Winne BURCHARD BE (1965). “Blumer’s shelf tumor with primary carcinoma of the lung. A case report”. J Int Coll Surg. 44 (5): 477β81. PMIDΒ 5828299.
- β Gilliland R, Gill PJ (1992). “Incidence and prognosis of Krukenberg tumour in Northern Ireland”. Br J Surg. 79 (12): 1364β6. PMIDΒ 1336701.
- β Antman KH, Skarin AT, Mayer RJ, Hargreaves HK, Canellos GP (1979). “Microangiopathic hemolytic anemia and cancer: a review”. Medicine (Baltimore). 58 (5): 377β84. PMIDΒ 481196.
- β Wakashin M, Wakashin Y, Iesato K, Ueda S, Mori Y, Tsuchida H; et al. (1980). “Association of gastric cancer and nephrotic syndrome. An immunologic study in three patients”. Gastroenterology. 78 (4): 749β56. PMIDΒ 6986318.
- β Carmack SW, Genta RM, Graham DY, Lauwers GY (2009). “Management of gastric polyps: a pathology-based guide for gastroenterologists”. Nat Rev Gastroenterol Hepatol. 6 (6): 331β41. doi:10.1038/nrgastro.2009.70. PMIDΒ 19421245.
- β Rugge M, Meggio A, Pennelli G, Piscioli F, Giacomelli L, De Pretis G; et al. (2007). “Gastritis staging in clinical practice: the OLGA staging system”. Gut. 56 (5): 631β6. doi:10.1136/gut.2006.106666. PMCΒ 1942143. PMIDΒ 17142647.
Editor-In-Chief:
C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Parminder Dhingra, M.D. [2]
