Primary retroperitoneal seminoma presenting as renal colic

We describe a case of primary retroperitoneal seminoma, presenting as intractable renal colic. Awareness of this entity might lead us to a correct preoperative diagnosis.     

Primary central nervous system lymphoma presenting as autonomic dysfunction

Summary We describe a patient with primary central nervous system lymphoma (PCNSL) who presented with symptoms of subacute onset of dysautonomia. Autonomic testing indicated a peripheral autonomie neuropathy while magnetic resonance imaging revealed brainstem involvement. We propose that this patient's autonomie dysfunction could be the result of a paraneoplastic syndrome and PCNSL should be considered in the differential diagnosis of dysautonomia.     

Primary CNS lymphoma presenting as fever of unknown origin

We report a case of fever of unknown origin in an immunocompetent patient as the first manifestation of primary central nervous lymphoma. To our knowledge this is the first reported case in the literature of this association. We recommend brain imaging to be considered in patients presenting with fever of unknown origin and no apparent diagnosis after extensive investigation.     

Primary gastric signet ring cell carcinoma presenting as cardiac tamponade

Primary gastric signet ring cell carcinoma presenting as cardiac tamponade is difficult to diagnosis early.Patients are generally asymptomatic until the disease is advanced.General practitioners usually focus on the initial symptoms related to pericarditis and pericardial effusion.We report a case of signet-ring cell carcinoma of the stomach presenting as cardiac tamponade with pericarditis and pericardial effusion but without any gastrointestinal symptoms.A 49-year old woman was admitted because of progressive dyspnea and cough.Chest X-ray revealed an increased cardiothoracic ratio and a small amount of bilateral pleural effusion.Two dimensional ultrasonographic echocardiography pericardial effusions with atrial and right ventricular early diastolic collapse were found,establishing the diagnosis of cardiac tamponade.Pericardiocentesis was performed and 420 mL of bloody fluid was taken.The patient died of respiratory failure and cardiac arrest on October 28,2009.Post-mortem examination revealed diffuse gastric mucosa erosion and edema with stomach mucosa incrassation in the greater curvature.The primary lesion was histopathologically diagnosed as signet-ring cell carcinoma of the stomach.     

Primary pulmonary tuberculosis presenting as mass lesions and simulating tumours in children

Two cases of primary pulmonary tuberculosis presenting as mass densities and simulating neoplasms in children are reported. This manifestation has not been previously reported in children. It probably represents an unusual immunological response to the mycobacterium.