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Atraumatic spinal epidural hematomas have been reported as an initial presentation of multiple myeloma.
Although rare as an initial presentation, ovarian type serous carcinoma of the paratestis should be included in the differential diagnosis in males with abdominal metastases that show papillary architecture, psamommatous calcifications and PAX8 immunoreactivity.
It is often diagnosed as an initial presentation of HIV infection affecting short- and longer-term survival.
Although evident in younger age groups, heart failure and ischemic stroke as an initial presentation started to increase in both sexes at age 60 to form the 2 most common initial presentations at age >80.
The authors report a case of pleural effusion as an initial presentation of Acute Myeloid Leukemia (AML) in an adult patient with no physical exam findings suggestive of leukemia and or malignancy.
Peritoneal lymphomatosis can be seen as an initial presentation of lymphoma (Fig. 3) but it can also develop during the course of disease or even as a manifestation of transformation of an indolent subtype of lymphoma to a higher grade, most commonly diffuse large B-cell lymphoma (Figs. 5 and 9).
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An initial presentation with AIDS or a CD4 cell count below 200 cells/mm is now referred to as "advanced disease", and an initial presentation with AIDS or a CD4 cell count below 350 cells/mm as "late HIV diagnosis" [ 3, 4].
Eighty-seven patients had an initial presentation of suspected lymphoma.
The incidence of rupture is reported to be as high as 33% at initial presentation with a mortality rate at open surgical repair of 33 50% [ 1, 2].
GIST rarely metastasizes to lymph nodes, except for a special subtype of SDH-mutated GIST [ 10], and its spread to the extra-abdominal organs is extremely rare as an initial metastatic presentation.
Open image in new window Fig. 1 Superior vena cava syndrome (SVCS) as the initial presentation of a stage IIIB small cell lung cancer in a 48-year-old woman.
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