Metastatic renal cancer, back pain, abnormal CT findings. Allowing for differences in technique and slice selection, there is no significant change in overall size of destructive lesion involving the L1 vertebral body extending into the bilateral posterior elements, left greater than right, and associated with osseous expansion. There is mild to moderate narrowing of the left L1-L2 neural foramen where the tumor abuts the left L1 nerve root. There is also mild narrowing of the left T12-L1 neural foramina. There is convex bulging posteriorly of the L1 vertebral body into the ventral epidural space contributing to mild narrowing of the spinal canal at this level and similar to prior. Minimal epidural enhancement at this level is favored to be reactive. No convincing evidence of epidural or leptomeningeal tumor.Vertebral body heights in the lumbar spine are preserved. There are prominent degenerative changes at the L4-L5 level with grade 1 anterolisthesis, significant disc height loss, advanced bilateral facet arthropathy, and moderate degree of spinal canal stenosis at this level. There is mild spinal canal narrowing at L3-L4 and to an even lesser degree at L2-L3 similar to prior. Moderate right L3-L4 and moderate right L4-L5 neural foramen stenosis also again seen. Up to moderate left L5-S1 neural foraminal narrowing also again seen. These findings are not significant changed since prior.Status post left nephrectomy. Right superior pole renal mass better assessed on prior abdominal CT.
1. Compared to MRI dated 12/20/2014, there is no significant change in size of the destructive metastatic lesion involving the L1 vertebral body and posterior elements. There is convex posterior bulging of the vertebral body at this level contributing to mild spinal canal stenosis at this level. There is also mild to moderate degree of neural foraminal narrowing at the left L1-L2 and T12-L1 levels related to the tumor also similar to prior. No new lesions are appreciated.2. Degenerative changes are again seen including moderate spinal canal stenosis at the L4-L5 level associated with grade 1 anterolisthesis. There is also moderate degree of right-sided neural foraminal stenosis at this level on a degenerative basis. These findings are not significantly changed in the interval.