Abdominal mass resident survival guide: Difference between revisions
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:❑[[Hemangioma]]s <br> | :❑[[Hemangioma]]s <br> | ||
:❑Undifferentiated pleomorphic [[sarcoma]]s <br> | :❑Undifferentiated pleomorphic [[sarcoma]]s <br> | ||
❑[[Metastasis]]<br> | ❑[[Metastasis]]<br> | ||
❑Tumor-like mass<br> | ❑Tumor-like mass<br> | ||
Line 61: | Line 60: | ||
:❑Primary malignant:[[Hepatocellular carcinoma|HCC]], [[cholangiocarcinoma]]<br> | :❑Primary malignant:[[Hepatocellular carcinoma|HCC]], [[cholangiocarcinoma]]<br> | ||
:❑Metastatic: [[Hemangioma]], [[lymphoma]],<br> [[myeloma]] and solid tumors.<br> | :❑Metastatic: [[Hemangioma]], [[lymphoma]],<br> [[myeloma]] and solid tumors.<br> | ||
❑[[Cholestasis]] ([[Primary biliary cirrhosis|PBC]], [[Primary sclerosing cholangitis|PSC]]) | D02=<div style="float: left; text-align: left; width: 18em; padding:1em;">'''Splenic mass'''<ref name="pmid29135986">{{cite journal |vauthors=Curovic Rotbain E, Lund Hansen D, Schaffalitzky de Muckadell O, Wibrand F, Meldgaard Lund A, Frederiksen H |title=Splenomegaly - Diagnostic validity, work-up, and underlying causes |journal=PLoS ONE |volume=12 |issue=11 |pages=e0186674 |date=2017 |pmid=29135986 |pmc=5685614 |doi=10.1371/journal.pone.0186674 |url=}}</ref><br>❑[[Infections|Infectious]] | ❑[[Cholestasis]] ([[Primary biliary cirrhosis|PBC]], [[Primary sclerosing cholangitis|PSC]]) | D02=<div style="float: left; text-align: left; width: 18em; padding:1em;">'''Splenic mass'''<ref name="pmid29135986">{{cite journal |vauthors=Curovic Rotbain E, Lund Hansen D, Schaffalitzky de Muckadell O, Wibrand F, Meldgaard Lund A, Frederiksen H |title=Splenomegaly - Diagnostic validity, work-up, and underlying causes |journal=PLoS ONE |volume=12 |issue=11 |pages=e0186674 |date=2017 |pmid=29135986 |pmc=5685614 |doi=10.1371/journal.pone.0186674 |url=}}</ref><br>❑[[Infections|Infectious]] ([[Infectious Mononucleosis|IM]], [[liver abscess]], [[echinococcosis]])<br>❑[[Myeloproliferative disorders|Myeloproliferative]] ([[lymphoma]]s<br> and [[leukemia]]s)<br> | ||
❑Storage ([[Gaucher’s disease|Gaucher's]], [[Niemann-Pick disease]])<br>❑Infiltrative:[[amyloidosis]], [[sarcoidosis]]<br> | ❑Storage ([[Gaucher’s disease|Gaucher's]], [[Niemann-Pick disease]])<br>❑Infiltrative:[[amyloidosis]], [[sarcoidosis]]<br> | ||
❑Miscellineous ([[Portal hypertension|PH]], [[metastases]] ([[lung cancer]] or [[breast cancer]], [[Felty's syndrome]])| D03=<div style="float: left; text-align: left; width: 18em; padding:1em;">'''Pancreatic mass'''<ref name="pmid27065727">{{cite journal |vauthors=Karoumpalis I, Christodoulou DK |title=Cystic lesions of the pancreas |journal=Ann Gastroenterol |volume=29 |issue=2 |pages=155–61 |date=2016 |pmid=27065727 |pmc=4805734 |doi=10.20524/aog.2016.0007 |url=}}</ref><ref name="pmid21620466">{{cite journal |vauthors=Vincent A, Herman J, Schulick R, Hruban RH, Goggins M |title=Pancreatic cancer |journal=Lancet |volume=378 |issue=9791 |pages=607–20 |date=August 2011 |pmid=21620466 |pmc=3062508 |doi=10.1016/S0140-6736(10)62307-0 |url=}}</ref><br>❑[[Pancreatic cyst]]<br> | ❑Miscellineous ([[Portal hypertension|PH]], [[metastases]] ([[lung cancer]] or [[breast cancer]], [[Felty's syndrome]])| D03=<div style="float: left; text-align: left; width: 18em; padding:1em;">'''Pancreatic mass'''<ref name="pmid27065727">{{cite journal |vauthors=Karoumpalis I, Christodoulou DK |title=Cystic lesions of the pancreas |journal=Ann Gastroenterol |volume=29 |issue=2 |pages=155–61 |date=2016 |pmid=27065727 |pmc=4805734 |doi=10.20524/aog.2016.0007 |url=}}</ref><ref name="pmid21620466">{{cite journal |vauthors=Vincent A, Herman J, Schulick R, Hruban RH, Goggins M |title=Pancreatic cancer |journal=Lancet |volume=378 |issue=9791 |pages=607–20 |date=August 2011 |pmid=21620466 |pmc=3062508 |doi=10.1016/S0140-6736(10)62307-0 |url=}}</ref><br>❑[[Pancreatic cyst]]<br> | ||
Line 70: | Line 69: | ||
:❑[[Adenocarcinoma]]s ([[Pancreatic cancer classification|ductal]], [[bile duct]], [[Pancreatic cancer classification|ampullar]] and [[Small intestine cancer classification|duodenal]]) | :❑[[Adenocarcinoma]]s ([[Pancreatic cancer classification|ductal]], [[bile duct]], [[Pancreatic cancer classification|ampullar]] and [[Small intestine cancer classification|duodenal]]) | ||
:❑[[Pancreatic neuroendocrine tumor]]s<br> | :❑[[Pancreatic neuroendocrine tumor]]s<br> | ||
:❑Others ([[lymphoma]] and [[metastasis]])| D04=<div style="float: left; text-align: left; width: 14em; padding:1em;">'''[[Retroperitoneal]] mass'''<ref name="pmid30559557">{{cite journal |vauthors=Mota MMDS, Bezerra ROF, Garcia MRT |title=Practical approach to primary retroperitoneal masses in adults |journal=Radiol Bras |volume=51 |issue=6 |pages=391–400 |date=2018 |pmid=30559557 |pmc=6290739 |doi=10.1590/0100-3984.2017.0179 |url=}}</ref><br>(majority tumors are [[malignant]])<br> | :❑Others ([[lymphoma]] and [[metastasis]])| D04=<div style="float: left; text-align: left; width: 18em; padding:1em;">'''[[Gastrointestine|GI]] and [[Genitourinary system|Genitourinary]] mass'''<ref name="pmid18300338">{{cite journal |vauthors=Maconi G, Manes G, Porro GB |title=Role of symptoms in diagnosis and outcome of gastric cancer |journal=World J. Gastroenterol. |volume=14 |issue=8 |pages=1149–55 |date=February 2008 |pmid=18300338 |pmc=2690660 |doi=10.3748/wjg.14.1149 |url=}}</ref><ref name="pmid22272565">{{cite journal |vauthors=Sharma A, Naraynsingh V |title=Distended bladder presenting with constipation and venous obstruction: a case report |journal=J Med Case Rep |volume=6 |issue= |pages=34 |date=January 2012 |pmid=22272565 |pmc=3398309 |doi=10.1186/1752-1947-6-34 |url=}}</ref><ref name="pmid15361501">{{cite journal |vauthors=Caricato M, Ausania F, Borzomati D, Valeri S, Coppola R, Verzì A, Tonini G |title=Large abdominal mass in Crohn's disease |journal=Gut |volume=53 |issue=10 |pages=1493, 1503 |date=October 2004 |pmid=15361501 |pmc=1774217 |doi=10.1136/gut.2003.035956 |url=}}</ref><ref name="pmid29258579">{{cite journal |vauthors=Yeika EV, Efie DT, Tolefac PN, Fomengia JN |title=Giant ovarian cyst masquerading as a massive ascites: a case report |journal=BMC Res Notes |volume=10 |issue=1 |pages=749 |date=December 2017 |pmid=29258579 |pmc=5735515 |doi=10.1186/s13104-017-3093-8 |url=}}</ref><br> | ||
❑[[Liposarcoma]]<br> | ❑[[Gastrointestine|GI]]<br> | ||
:❑[[Volvulus]]<br> | |||
:❑[[IBD]]<br> | |||
:❑[[Colon cancer]]<br> | |||
:❑[[Gastric cancer]]<br> | |||
:❑[[Cholecystitis]]<br> | |||
❑[[Genitourinary system]] | |||
:❑[[Bladder]] distension<br> | |||
:❑[[Ovarian cyst]]/ [[ovarian cancer]]<br> | |||
:❑[[Leiomyoma]]<br> | |||
:❑[[Ureteropelvic junction obstruction]]<br> | |||
:❑[[Testicular cancer]]|D05=<div style="float: left; text-align: left; width: 14em; padding:1em;">'''[[Retroperitoneal]] mass'''<ref name="pmid14565853">{{cite journal |vauthors=Schrader AJ, Anderer G, von Knobloch R, Heidenreich A, Hofmann R |title=Giant hydronephrosis mimicking progressive malignancy |journal=BMC Urol |volume=3 |issue= |pages=4 |date=October 2003 |pmid=14565853 |doi=10.1186/1471-2490-3-4 |url=}}</ref><ref name="pmid30568516">{{cite journal |vauthors=Ojha U, Ojha V |title=Renal cell carcinoma presenting as nonspecific gastrointestinal symptoms: a case report |journal=Int Med Case Rep J |volume=11 |issue= |pages=345–348 |date=2018 |pmid=30568516 |doi=10.2147/IMCRJ.S178816 |url=}}</ref><ref name="pmid30559557">{{cite journal |vauthors=Mota MMDS, Bezerra ROF, Garcia MRT |title=Practical approach to primary retroperitoneal masses in adults |journal=Radiol Bras |volume=51 |issue=6 |pages=391–400 |date=2018 |pmid=30559557 |pmc=6290739 |doi=10.1590/0100-3984.2017.0179 |url=}}</ref><br>(majority tumors are [[malignant]])<br> | |||
❑[[Hydronephrosis]]<br> | |||
❑[[Liposarcoma]]/ [[sarcoma]]<br> | |||
❑[[Incidentaloma]]<br> | ❑[[Incidentaloma]]<br> | ||
❑[[Lymphoma]] | ❑[[Lymphoma]]<br> | ||
❑[[Renal cell carcinoma]]<br> | |||
❑[[Abdominal Aortic Aneurysm]]'''(AAA)|}} | |||
{{familytree/end}} | {{familytree/end}} | ||
Revision as of 14:04, 14 August 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: , Javaria Anwer M.D.[2]
Synonyms and keywords: abdominal lump resident survival guide
Overview
An abdominal mass is a vast entity in oncology.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated. The life-threatening causes of an abdominal mass include:
- Abdominal aortic aneurysm, specifically ruptured abdominal aortic aneurysm. Total mortality is estimated to be 80–90 %. The 2013 mortality rate of US population above 44 years of age was 2.5 per 100,000. The incidence is on the decrease for the past two decades after a plateau. (the mortality rates act as a surrogate of incidence).[1]
- Volvulus
Common Causes
Common causes of an abdominal mass described below follow a descending order. The list is based on a retrospective study from Turkey among 45 adult patients who underwent surgery because of an intra-abdominal mass (between May 2010 and May 2017).[2]
Benign pathologies
- Mesenteric cyst
- Endometriosis
- Hydatid cyst
- Fibroma
- Dystrophic calcification
- Aberrant pancreas
- Leiomyoma
- Pseudocyst
Malignant pathologies
- Gastrointestinal stromal tumor (GIST)
- Liposarcoma
- Ovarian tumor
- Chondrosarcoma
- Neuroendocrine tumor
- Malignt mesenchymal tumor
- Lymphoma
- Schwannoma
- The following chart illustrates the probable causes of an abdominal mass based on the location and salient features.
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Diagnosis
Shown below is an algorithm summarizing the diagnosis of abdominal mass according the the [...] guidelines.
Treatment
Shown below is an algorithm summarizing the treatment of abdominal mass according the the [...] guidelines.
Do's
- Start the assessment of a patient with an abdominal mass using the pneumonic "ABC:" airway, breathing and circulation, to identify an unstable patient.
- Taking careful history, and thorough physical examination are crucial to creating narrow differential diagnoses.
- Among females of childbearing age (average age 12 and 51 or start of menstrual cycle till menopause), pregnancy screening (usually a urine pregnancy test) should be performed before diagnostic radiation exposure or interventions such as fluoroscopy‐guided interventions.[18][19]
- Order an ultrasound or MRI among pregnant females to avoid exposure to radiation.
- Perform a pelvic and testicular examination among patients with lower abdominal pain.
- Correlate the CD4 count in HIV positive patients with the most commonly occurring pathology.
- Abdominal aortic aneurysm and malignancy are more important considerations among patients above 50 years of age than for younger patients.
- Suspect ruptured abdominal aortic aneurysm in old patients presenting with a pulsating mass, associated abdominal pain and a history of tobacco use.[20]
Don'ts
- The content in this section is in bullet points.
References
- ↑ Starnes, Benjamin (2017). Ruptured abdominal aortic aneurysm : the definitive manual. Cham: Springer. ISBN 978-3-319-23844-9.
- ↑ "cms.galenos.com.tr" (PDF).
- ↑ "ACS/ASE Medical Student Core Curriculum".
- ↑ Jo VY, Fletcher CD (February 2014). "WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition". Pathology. 46 (2): 95–104. doi:10.1097/PAT.0000000000000050. PMID 24378391.
- ↑ Li M, Zhang L, Xu XJ, Shi Z, Zhao XM (November 2019). "CT and MRI features of tumors and tumor-like lesions in the abdominal wall". Quant Imaging Med Surg. 9 (11): 1820–1839. doi:10.21037/qims.2019.09.03. PMC 6902146 Check
|pmc=
value (help). PMID 31867236. - ↑ vom Dahl S, Mengel E (October 2010). "Lysosomal storage diseases as differential diagnosis of hepatosplenomegaly". Best Pract Res Clin Gastroenterol. 24 (5): 619–28. doi:10.1016/j.bpg.2010.09.001. PMID 20955964.
- ↑ Maharaj B, Cooppan RM, Maharaj RJ, Desai DK, Ranchod HA, Siddie-Ganie FM, Goqwana MB, Ganie AS, Gaffar MS, Leary WP (February 1986). "Causes of hepatomegaly at King Edward VIII Hospital, Durban. A prospective study of 240 black patients". S. Afr. Med. J. 69 (3): 183–4. PMID 3003936.
- ↑ Curovic Rotbain E, Lund Hansen D, Schaffalitzky de Muckadell O, Wibrand F, Meldgaard Lund A, Frederiksen H (2017). "Splenomegaly - Diagnostic validity, work-up, and underlying causes". PLoS ONE. 12 (11): e0186674. doi:10.1371/journal.pone.0186674. PMC 5685614. PMID 29135986.
- ↑ Karoumpalis I, Christodoulou DK (2016). "Cystic lesions of the pancreas". Ann Gastroenterol. 29 (2): 155–61. doi:10.20524/aog.2016.0007. PMC 4805734. PMID 27065727.
- ↑ Vincent A, Herman J, Schulick R, Hruban RH, Goggins M (August 2011). "Pancreatic cancer". Lancet. 378 (9791): 607–20. doi:10.1016/S0140-6736(10)62307-0. PMC 3062508. PMID 21620466.
- ↑ Maconi G, Manes G, Porro GB (February 2008). "Role of symptoms in diagnosis and outcome of gastric cancer". World J. Gastroenterol. 14 (8): 1149–55. doi:10.3748/wjg.14.1149. PMC 2690660. PMID 18300338.
- ↑ Sharma A, Naraynsingh V (January 2012). "Distended bladder presenting with constipation and venous obstruction: a case report". J Med Case Rep. 6: 34. doi:10.1186/1752-1947-6-34. PMC 3398309. PMID 22272565.
- ↑ Caricato M, Ausania F, Borzomati D, Valeri S, Coppola R, Verzì A, Tonini G (October 2004). "Large abdominal mass in Crohn's disease". Gut. 53 (10): 1493, 1503. doi:10.1136/gut.2003.035956. PMC 1774217. PMID 15361501.
- ↑ Yeika EV, Efie DT, Tolefac PN, Fomengia JN (December 2017). "Giant ovarian cyst masquerading as a massive ascites: a case report". BMC Res Notes. 10 (1): 749. doi:10.1186/s13104-017-3093-8. PMC 5735515. PMID 29258579.
- ↑ Schrader AJ, Anderer G, von Knobloch R, Heidenreich A, Hofmann R (October 2003). "Giant hydronephrosis mimicking progressive malignancy". BMC Urol. 3: 4. doi:10.1186/1471-2490-3-4. PMID 14565853.
- ↑ Ojha U, Ojha V (2018). "Renal cell carcinoma presenting as nonspecific gastrointestinal symptoms: a case report". Int Med Case Rep J. 11: 345–348. doi:10.2147/IMCRJ.S178816. PMID 30568516.
- ↑ Mota M, Bezerra R, Garcia M (2018). "Practical approach to primary retroperitoneal masses in adults". Radiol Bras. 51 (6): 391–400. doi:10.1590/0100-3984.2017.0179. PMC 6290739. PMID 30559557. Vancouver style error: initials (help)
- ↑ Abushouk AI, Sanei Taheri M, Pooransari P, Mirbaha S, Rouhipour A, Baratloo A (2017). "Pregnancy Screening before Diagnostic Radiography in Emergency Department; an Educational Review". Emerg (Tehran). 5 (1): e60. PMC 5585830. PMID 28894775.
- ↑ Gungor S, Celebi E (November 2019). "Detection of unrecognized pregnancy prior to a fluoroscopy-guided interventional procedure: A case report". Clin Case Rep. 7 (11): 2207–2211. doi:10.1002/ccr3.2437. PMC 6878093 Check
|pmc=
value (help). PMID 31788280. - ↑ "Diagnosis and management of 528 abdom... [Br Med J (Clin Res Ed). 1981] - PubMed - NCBI".