Introduction: Extraskeletal mesenchymal chondrosarcoma (ESMC) is rare, aggressive, and high grade malignant tumors originating from soft tissues. It carries a poor prognosis with a tendency for local recurrence and distant metastasis, necessitating long-term follow-up. The most common sites for metastasis are the lungs, bones, and lymph nodes. Meanwhile, pancreatic metastases are extremely rare. Case Description: A 35-year-old female presented with a history of wide local excision for the left upper limb mass; histopathology showed ESMC. She was on surveillance with a computed tomography scan of the thorax and magnetic resonance imaging of the left upper limb at 3-months intervals until she developed vertebral and pancreatic lesions after 6 months post-surgery. No pulmonary metastases were noted. Considering the unusual site for metastasis and to exclude the possibility of any second malignancy, bone biopsy, and endoscopic ultrasound-guided fine-needle aspiration was performed that confirmed metastases. Later she developed osseous metastases in the pelvis and femora. Practical Implication: Pancreatic metastasis from ESMC is extremely rare. In case of new visceral or osseous lesions in a patient with a past medical history of ESMC, the possibility of metastatic disease should be considered. A biopsy can be performed to confirm the diagnosis.

Background: Recent advances in imaging technology has made it possible to diagnose abdominal masses in the early stages along with accurate image-guided localization of biopsy sites. Contrast-enhanced Computed tomography (CECT) abdomen is one such imaging tool. This study aims to establish the diagnostic accuracy of CT scans in detecting Wilm's tumour.

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19

Background: Magnetic Resonance Imaging (MRI) has a premier role in detecting rectal cancer and is considered superior for diagnosing tumour recurrences. It is the modality of choice by which patients with total abdominal perineal (AP) resection can be fully evaluated. This study aimed to evaluate the diagnostic accuracy of MRI in the detection of rectal carcinoma in suspected cases, keeping histopathology as a gold standard. Methodology: A descriptive cross-sectional study was conducted in the radiology department of Dow University of Health Sciences, Civil Hospital, Karachi, from 19th May to 18th November 2018. A total of 181 patients with a history of bleeding per rectum, altered bowel habits and abdominal pain were included. High-resolution 2D T2-weighted fast spin-echo sequences in the sagittal, axial and coronal planes were taken. Patients were followed for histopathology reports. The diagnostic accuracy of MRI for rectal carcinoma was calculated in terms of diagnostic accuracy, sensitivity, specificity, using histopathology as a gold standard. Results: There were 63% male and 37% female patients. The mean symptoms duration was 60.61 ± 7.18 weeks. 64.1% were presented with bleeding per rectum, 52.5% with altered bowel habits and 31.5% with abdominal pain. 35.4% of cases were diagnosed positive by MRI, and 43.6% cases through histopathology. Sensitivity, Specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 85.9%, 79.5%, 69.6%, 91.2%, and 81.76% respectively. Conclusion: It was concluded that MRI has 85.9% sensitivity, 79.5% specificity, and 81.76% diagnostic accuracy in detecting rectal cancers proving its reliability in detecting both early and recurrent rectal cancers.

Introduction: Colon cancer is one of the leading malignancies globally and continues to be one of the most typical causes of cancer-related mortality. The clinical outcome of the disease depends on the primary tumor stage, regional nodal involvement, and distant disease dissemination. It often presents with hematogenous spread to the liver at the time of diagnosis. Another factor for increased mortality is the presence of extramural venous invasion (EMVI). This is exceedingly important as it has significant prognostic significance and helps predict survival. Case Description: A middle-aged female with a recent history of cesarean delivery presented with abdominal pain and occasional constipation, which led to a series of investigations. Initial Computed Tomography (CT) scan showed proximal to mid transverse colonic tumoral thickening with locoregional lymphadenopathy and solitary distant metastasis in the left hepatic lobe. This was followed by extended right hemicolectomy and hepatic metastasectomy.  The patient remained on follow-up and later presented with thrombus formation in the splenoportal circulation. Initially, this was considered a bland thrombus, and the patient was advised a close follow-up. However, the patient was lost to follow and later presented with extensive thrombosis of the portal and splenic veins. Practical Implications: Confident differentiation of the bland versus malignant thrombosis is crucial to ascertain disease stage and appropriate management. Invasive tissue sampling gives a confident diagnosis of benign versus malignant thrombus. However, using a noninvasive imaging modality, we can still distinguish between the two with reasonable certainty.