Adrenocortical carcinoma physical examination
Adrenocortical carcinoma Microchapters
Adrenocortical carcinoma physical examination On the Web
American Roentgen Ray Society Images of Adrenocortical carcinoma physical examination
Appearance of the patient
- Moon-like face
- Buffalo hump
- Patients may appear flushed due to the associated increase in erythropoietin secretion.
- Patients may appear obese due to associated type2 diabetes mellitus and Cushing's syndrome.
- 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
- 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, and proximal muscle weakness
- 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
- 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.
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity
- Nieman LK (2015). "Cushing's syndrome: update on signs, symptoms and biochemical screening.". Eur J Endocrinol. 173 (4): M33–8. PMC . PMID 26156970. doi:10.1530/EJE-15-0464.
- La Batide-Alanore A, Chatellier G, Plouin PF (2003). "Diabetes as a marker of pheochromocytoma in hypertensive patients.". J Hypertens. 21 (9): 1703–7. PMID 12923403. doi:10.1097/01.hjh.0000084729.53355.ce.
- Drénou B, Le Tulzo Y, Caulet-Maugendre S, Le Guerrier A, Leclercq C, Guilhem I; et al. (1995). "Pheochromocytoma and secondary erythrocytosis: role of tumour erythropoietin secretion.". Nouv Rev Fr Hematol. 37 (3): 197–9. PMID 7567437.