History of multiple myeloma and breast and endometrial adenocarcinomas status post recent cervical spine tumor resection. There are postoperative findings related to recent C4 through C6 laminectomy with posterior rods and screws. There is a fluid collection with mildly convex margins and layering intermediate T1 and T2 components in the posterior extradural portion of the surgical bed in addition to what corresponds to floseal. The fluid collection measures approximately 20 AP x 25 RL x 50 SI mm. In conjunction with reversal of the usual lordosis, posterior disc-osteophyte complexes, and ossification of the posterior longitudinal ligament, there appears to be slight mass effect upon the spinal cord. There is diffuse high T2 signal in the spinal cord from C2 to C7. There is a small amount of residual intradural extramedullary tumor within the left aspect of the spinal canal at the C3-4 and C4-5 levels that measures up to 2 mm in thickness, as well as unchanged thickening and enhancement along the exiting left C4 and C5 nerve roots that extends beyond the neural foramina. There are multiple T2 hyperintense enhancing lesion in the imaged portions of the axial skeleton, including the T1 and T4 vertebrae and manubrium. The vertebral body heights appears to be preserved nevertheless. There is right axillary, supraclavicular, and parotid lymphadenopathy. There are bilateral maxillary sinus retention cysts.
1. Postoperative findings related to resection of a spinal cord tumor with a fluid collection containing a probable hematocrit level in the epidural compartment of the surgical bed contributes to slight mass effect upon the spinal cord at C4 through C7 in conjunction with reversal of the usual lordosis, posterior disc-osteophyte complexes, and ossification of the posterior longitudinal ligament. Nevertheless, the overall mass effect is markedly reduced compared to before surgery.2. A small amount of residual tumor is evident within the left aspect of the spinal canal at the C3-4 and C4-5 levels with extension along the exiting left C4 and C5 nerve roots beyond the neural foramina. 3. Diffuse signal abnormality in the cervical spinal cord may represent residual edema or sequela prior ischemic changes.4. Multiple lesions in the imaged axial skeleton are compatible with neoplasm.5. Right axillary, supraclavicular, and parotid lymphadenopathy likely represent neoplasm as well. Please refer to the prior neck CT report for additional details.Discussed with Dr. Lesniak on 4/24/2015 at 9:30 AM.