A 47 years old women with no prior comorbidities, presented with a 3 months history of abdominal distension with insidious pain, weight loss and fatigue. The patient underwent an abdominal computed tomography scan, that showed bilateral ovarian masses, large, well defined, and mixed solid and cystic, with enhancement of the solid component (Figure 1A & 1B).

A 41-year-old patient presents a prolonged ileus with abdominal tendernesss even days after an anterior resection with total excision of the mesorectum and latero terminal colorectal anastomosis for a rectal adenocarcinoma. The laboratory results reveal elevated CRP levels. An abdomino-pelvic CT scan with low water-soluble opacification shows a leakage of the contrast media with individualization of a parietal defect next to the colorectal anastomosis (Figure 1), feeding a pre-sacral collection mimicking a rectal lumen in a “double rectum sign” appearance (Figure 2A & B).

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A 57 year old woman with no past medical history presented with headaches and progressive left vision loss. Subsequently, a contrast enhanced brain MRI was performed showing a large well defined skull base mass located laterally in the left petro clival fissure, exhibiting high T2 and FLAIR signal intensity (Figure A), with areas of low signal intensity on susceptibility weighted images consistent with calcifications and a heterogenous enhancement after injection. This tumor was responsible for mass effect on the orbital apex and optic nerve anteriorly and the mesio temporal lobe laterally. Most importantly, on the sagittal planes we can see the tumor projection indenting the pons which is displaced posteriorly. This finding is known as the thumb sign (Figure B and C) characteristic of chordomas. Given these MRI features and after a stereotactic biopsy the diagnosis of chordoma of the skull base was confirmed. Because of the major local extension, the patient underwent radiotherapy rather than surgical resection. Chordomas are rare skull base tumors arising from embryonal rest cells [1]. The major differential being chondrosarcomas with similar appearance but higher ADC values. The thumb sign is relatively specific of chordomas [2] although itcan be described in chondromas of the skull base and can also be seen in chondrosarcomas.

Orbital lymphoma is a rare cause of primary Non Hodgkin lymphomasand represents a major cause of orbital malignancies, usually arising from extraocular muscles, eyelid, and soft tissue adnexa. Overall it presents as an extraconal tumor featuring a broad spectrum of clinical presentation making the diagnosis sometimes challenging. We report the case of a 65 year old male with no prior medical history presenting with a recent ongoing proptosis. Radiological findings were consistent with an extraconal lesion involving the lateral orbital wall responsible for mass effect on the globe and optic nerve, for which histopathological results showed features of a small lymphocytic lymphoma.