Fast Five Quiz: How Much Do You Know About Diagnosing and Treating Metastatic Colorectal Cancer?

Elwyn C. Cabebe, MD


July 02, 2019

GI cancers (usually CRC and stomach cancers) often metastasize to the abdomen and the pelvis, but may also spread along the urachus and produce nodules at the umbilicus—ie, the SMJ nodules. Although SMJ lesions are rare, approximately 52% of occurrences are due to GI cancer (predominantly gastric, colon, and pancreatic cancer), and 28% from gynecologic cancer (ovarian and uterine cancer); in the remaining cases, the origin is not known.

The Aaron sign refers to the pain felt in the epigastric region upon steady palpation over the McBurney point. The Rovsing sign is the presence of right lower quadrant pain upon palpation of the left lower quadrant of the abdomen. Both the Aaron and Rovsing signs are associated with appendicitis.

The Virchow node, or Troisier sign, refers to visible enlargement of the left-sided supraclavicular lymph node, which is supplied by abdominal lymphatic vessels; this sign is associated with gastric, ovarian, testicular, and renal cancers.

For more on the physical examination findings associated with metastatic carcinomas, read here.


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