Urinary bladder carcinoma is a common malignancy worldwide. The metastatic disease to distant organs including lung, liver, and bone is well established. However, metastasis to below-knee-level; also known as acrometastasis is a rare occurrence and occurs approximately 0.1% of all bone metastases. It is standard of care to obtain a contrast enhanced computed tomography scan of the chest, abdomen, and pelvis for pretreatment planning, primary staging, and post treatment disease surveillance. This makes the occurrence of acrometastasis harder to detect and may only manifest clinically in advance disease. We report a case of 55 years old gentleman treated as muscle-invasive bladder urothelial carcinoma, presented with chronic left knee pain, and imaging demonstrating tumor in the left knee region. Histopathologic study shows features of metastatic disease from urinary bladder carcinoma to the left gastrocnemius muscle. The attending physician should raise the suspicion of metastatic disease if the patient with known malignancy presented with new soft tissue lesion elsewhere in the body.

Pulmonary sclerosing pneumocytoma (PSP) is a rare condition, occupying only approximately 1% of all benign lung neoplasms and the description of this disease through a radiological perspective is limited. Only approximately a third of PSP has been correctly diagnosed pre-operatively through contrast-enhanced computed tomography (CECT) thorax. To date, only few radiological features have been described to ascertain this disease and there is still a significant portion of patients being misdiagnosed with a malignant neoplasm.  We report a case of PSP that was initially misdiagnosed as lung adenocarcinoma stage IIA and the histopathological findings of surgical resection confirmed the diagnosis of PSP. We try to add some points from this case into the previous radiological description of this uncommon disease with a common presentation.

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Background: A demyelinating lesion can present as a space occupying lesion in Magnetic Resonance Imaging (MRI) brain. Lesions that have diameter greater than 2 cm is referred as tumefactive demyelinating lesion. These lesions can mimic a brain tumor, namely glioma or primary central nervous system lymphoma. Case presentation: We present two female patients over 30 years old who presented with limb weakness. Their MRI demonstrated typical appearance of a solitary, incomplete rim enhancing lesion that involved the subcortical white matter with minimal mass effect. Also, the rim of enhancement opened to the grey matter. Due to their typical appearance, biopsy was not performed. The lesions in both patients reduced in size upon follow up after treatment commencement and currently recovering. Conclusion: In this case report, we focus on discussing the MRI features of tumefactive demyelinating lesion and its main differentials, which are central nervous system lymphoma (CNSL) and glioma.