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Background: Numerous endometrial disorders can create several difficulties for the radiologist due to the overlapping of imaging characteristics and diverse endometrial pathologies. The most frequently utilized imaging tool for diagnosing and characterizing endometrial focal lesions is magnetic resonance imaging (MRI) with diffusion weighted images (DWI).Objective: We conducted this study to determine the efficacy of MRI with DWI in improving the diagnostic accuracy of endometrial focal lesions, especially in the differential diagnosis of benign and malignant focal endometrial masses. Patients and Methods: This study recruited 36 women (21 postmenopausal and 15 premenopausal) who experienced vaginal bleeding and had endometrial thickness and focal endometrial lesions with a distinct echo pattern on ultrasound (US) examination. The age of patients was between 27 to 85 years, with an average of 45.2 years. Ethics Committee approval was obtained in addition to written informed consent from all included patients. Results: The 36 patients included in this study, were classified according to their lesions histopathological results; Benign group (15 lesions; 41.67%) and malignant group (21 lesions; 58.33%). The most common benign lesion was endometrial polyp (9/15) while the most common malignant lesion was endometrial carcinoma (21/21). In the current study MRI with diffusion could correctly diagnose 33 lesions out of 36 lesions, achieving (91.6%) sensitivity, (100%) specificity, (100%) positive predictive value (PPV), (95.6%) negative predictive value (NPV) and accuracy (97.05 %). Conclusion: Integrating DWI and ADC mapping at a high b value in pelvic MRI examination improves the sensitivity, specificity, and precision of diagnosing endometrial focal lesions.

Background: Colorectal cancer (CRC) who is initially diagnosed with single or multiple synchronous distant metastases has an incidence of about 20% of all CRC patients. There is a controversy regarding the role of resection of the primary tumors in those patients. The aim of this study was to explore the prognostic roles and survival advantages of surgical excision of the primary colonic tumor in patients with CRC who are primarily diagnosed with distant metastases. Patients and Methods: We included forty patients who were diagnosed initially with stage IV CRC. We have divided the included patients into two categories the first one included 20 patients that underwent surgical excision of the primary cancer followed by administration of chemotherapy and the remaining 20 patients were initially given chemotherapy without excision of the cancer. We followed patients for 24 months to detect progression, response to chemotherapy, recurrence free survival and overall survival rates. Results: There is statistically significant difference between patients underwent different initial management techniques regarding N stage of the tumor (p = 0.039), response to chemotherapy (p = 0.048), occurrence of relapse (p = 0.022), disease free survival (DFS) (p = 0.027) or overall survival (OS) rates (p = 0.001) (DFS and OS were significantly higher among patients who received initial surgical management. Primary surgical removal of the tumor improved OS rate by 8 months (p = 0.001). Conclusion: Surgical removal of the primary malignancy in mCRC patients before chemotherapy How to cite this paper: