[Fat Bear Science] These abnormalities on the legs may indicate cancer

The early symptoms of cancer in different systems are different. However, cancer in the legs can be seen and felt, and may give certain "alarm" signals. If we can correctly understand these early signals from the legs, we can achieve early detection and early treatment.

Expert Profile

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Li Qingdong

Deputy Director and Chief Physician of the Vascular and Interventional Department, Affiliated Cancer Hospital of Chongqing University.

Expert in comprehensive treatment of liver cancer, comprehensive treatment of pancreatic cancer, radical resection of cholangiocarcinoma/gallbladder cancer, minimally invasive treatment of tumors (microwave/radiofrequency ablation, interventional, particle implantation therapy), surgery for vascular diseases, endovascular treatment, minimally invasive treatment of portal vein and inferior vena cava tumor thrombus, and minimally invasive treatment of metastatic liver tumors.

Clinic hours: Monday all day

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Zheng Wentao

Resident physician in the Department of Vascular and Interventional Medicine, Affiliated Cancer Hospital of Chongqing University.

He is good at minimally invasive treatment of tumor diseases and diagnosis and treatment of vascular surgical diseases, such as interventional treatment of liver cancer, endovascular treatment, minimally invasive treatment of tumors, tumor ablation, varicose veins of great saphenous veins, peripheral vascular atherosclerosis obliterans, thromboangiitis obliterans, arterial embolism, etc.

01

Unexplained swelling

There are a large number of blood vessels and nerves in the human legs. If cancer cells are rampant, they will gradually invade the blood vessels and nerves, causing swelling and pain in the patient's legs. The first symptoms of some cancer patients are lower limb discomfort, swelling and pain. When they go to the hospital for color Doppler ultrasound examinations, they find that the previously unobstructed veins are blocked by blood clots, and deep vein thrombosis of the lower limbs occurs, especially in patients with lung cancer, pancreatic cancer, and gynecological tumors. Cancer is accompanied by thrombosis. Most cancer patients have a hypercoagulable state of blood, and the flowing blood is prone to form solid thrombi.

Studies have confirmed that the incidence of thrombosis in different tumors is as follows: primary brain tumors (47%), pancreatic cancer (19.2%), gastric cancer (15.8%), and lung cancer (13.9%). The risk is also relatively high in hematological tumors, especially lymphomas;

Natural course: The risk of blood clots is greatest in the first three months after diagnosis. Therefore, if you find your legs swollen, go to the hospital for screening as soon as possible. If the blood clots are not caused by other reasons, you need to have a full body check to rule out whether it is caused by cancer.

02

Lump appears

Under normal circumstances, the skin of a person's legs is very smooth and delicate, but once a lump is found on the leg, you need to pay attention. In general, most of the lumps on the legs are benign multiple lipomas. However, there are also cases of leg metastasis. If there are the following manifestations, it is considered to be a malignant tumor such as lung cancer and prostate cancer: painless lumps, hard texture, soft like lips, tough like nose tip, hard like forehead; adhered to surrounding tissues; most of them grow faster, and will gradually grow from a few months to half a year, but slower growth is not ruled out; according to the location of the tumor, some patients experience pain at the beginning, and generally pain will occur in the late stage. For example, common synovial sarcoma, liposarcoma, rhabdomyosarcoma, and alveolar soft tissue sarcoma, early surgery is the key once discovered.

In addition, there is another part of the body that should also be watched out for. There are many lymph nodes in the inguinal area. Many tumors often manifest as enlarged lymph nodes in the inguinal area, such as malignant lymphoma and lymph node metastasis. Lymphoma can be seen in any age group. The enlarged inguinal lymph nodes are often painless and progressive, ranging from the size of soybeans to eggs, with medium hardness. Generally, there is no adhesion to the skin, and they do not fuse with each other in the early and middle stages, and they are movable. In the later stages, the lymph nodes can grow to a large size, or fuse into large masses with a diameter of more than 20 cm, invading the skin, and not healing for a long time after rupture. Once an early puncture biopsy diagnosis is discovered, standardized treatment is the key.

03

Leg color changes

Under suitable conditions, the skin on the legs generally does not change significantly. If the color of the legs gradually darkens, it may be due to metabolic abnormalities, and one of the factors that induce metabolic abnormalities is the invasion of cancer cells.

Clinically, it is rare for cancer to cause changes in the color of the skin on the legs, but malignant melanoma is an exception. Melanoma is a skin tumor induced by excessive proliferation of abnormal melanocytes. In the early stages, normal skin will develop melanin deposition or pigmented nevi will develop increased pigmentation and darker black. As the disease progresses, the lesions will slowly expand and increase in hardness, accompanied by a feeling of itching and pain. The specific manifestations are that some of the damaged parts of the patients are raised, plaque-like and nodular, and some are mushroom-like or cauliflower-like. The color also appears in gray-black, brown, light red and other messy colors. Skin squamous cell carcinoma is also often manifested as color changes, which can be transformed from keratosis, mucosal leukoplakia and other precancerous diseases. It not only has color changes, but is also often accompanied by a foul odor. The special smell can help with differential diagnosis.

04

Abnormal bulge

In addition to the masses caused by soft tissue malignant tumors, there is another type of disease that often causes abnormal leg bulges. Osteosarcoma lumps grow rapidly, so you can find a hard lump growing out of the bone. The surface temperature of the lump increases, and superficial veins can be seen on the skin surface. There may be varying degrees of tenderness on the surface of the lump and nearby soft tissues. As the lump grows, it causes limited joint movement and muscle atrophy. In addition, bone metastases, giant cell tumors of bone, chondromas, etc. often cause abnormal leg bulges, which can cause deformities, fractures, pain, etc. Once discovered, they should be hospitalized for treatment in the early stage.

To prevent cancer, it is recommended to start with a self-examination. The methods for leg examination are visual examination and palpation. During visual examination, first observe the size of the lesion, skin color changes, whether there are ulcers, sinus tracts, erythema formation, and whether there are surface varicose veins; during palpation, you can first gently touch the skin surface to see if the skin temperature is high or cold, whether there is a sense of arterial pulsation or fluid fluctuation, and gently press to see if there is pain. At the same time, feel the texture and size of the lump, whether there is adhesion around it, and whether there is mobility when pushing. If you feel vascular tremor, you can also use a stethoscope to auscultate. Once the above symptoms are found in the legs, it is key to go to the hospital for examination and treatment in time.

Text/Fat Bear

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Audit/Vascular and Interventional Department

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