Complications arising from intravenous buprenorphine abuse.

patient remained asymptomatic. CAD has been described in association with various conditions, including mainly lymphoproliferative disorders (78% of cases). In a review of the Medline database (1966–2006), we found 22 observations of patients with CAD who developed malignancies (breast, ovary, kidney, colon, thyroid, prostate, skin, tongue, urinary bladder or carcinoid tumor). We did not find another report of mediastinal seminoma-associated CAD. At seminoma diagnosis, the patient did not exhibit clonal population in his bone marrow. Other authors have previously reported autoimmune haemolytic anaemia in five patients with seminoma, although none of these five exhibited cold agglutinin disease. In our patient, the diagnosis of paraneoplastic CAD seems reasonable, as other causes were excluded, particularly haematologic malignancies, and after initiation of chemotherapy, the anaemia disappeared, Coombs’ test being slightly positive. When unexplained CAD is observed in patients, check for an underlying solid tumour. CAD should be included within the spectrum of paraneoplastic manifestations of seminoma.