Which physical findings are characteristic of hepatocellular adenoma (HCA)?

Updated: Feb 21, 2018
  • Author: Bradford A Whitmer, DO; Chief Editor: BS Anand, MD  more...
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Answer

The physical examination findings are often nonspecific. Patients may be asymptomatic, or they may appear ill, with pallor and abdominal distress. Note the following:

  • Palpable tender or nontender mass in the right hypochondrium

  • Findings consistent with hemorrhage

  • Vital signs

  • Tachycardia

  • Hypotension

  • Orthostasis

  • Head, ears, eyes, nose, and throat (HEENT) examination

  • Anicteric sclera (Jaundice has been reported due to compression of the biliary tree by the tumor.)

  • Possible pale conjunctiva, if hemorrhage has occurred

  • Cardiovascular findings - Tachycardia if actively bleeding

  • Abdominal findings

  • Possible right hypochondrial mass with or without tenderness

  • Possible hepatomegaly

  • Possible fluid wave in cases of hemoperitoneum

  • Possible peritoneal signs, including guarding or rebound in cases of tumor rupture

  • Skin findings - Possible Grey-Turner sign or Cullen sign in cases of hemoperitoneum

  • Examination findings of the neck, chest, and extremities - Unremarkable

  • Neurologic examination findings - Unremarkable


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