Secondary malignant neoplasm of bone [C79.51], Reason for Study: ^Reason: with metastatic breast cancer and concerning cervical spine lesion, back pain; please evaluate for risk of cord compression/nerve compression History: with metastatic breast cancer Cervical spine MRIThere are interval development of soft tissue signal intensity at the level of C3 and C4 vertebral bodies, and left side lateral mass. On Gad enhancement scan, the enhancing portion of the soft tissue mass extend toward left side C23 and C34 neuroforamen as well as transverse foramen and encasing vertebral artery.Diffuse bulging of disc at the level of C45 and broad based disc protrusion central to right laterally at the level of C56 do not show any interval change since prior scan.At the level of C56 in conjunction with protruded disc with bilateral ligamentum flavum results mild to moderate spinal canal stenosis, grossly unchanged since prior scan.Spinal cord signal intensity is normal. There is normal cervical lordosis. The cranial-cervical junction is normal. Thoracic spine MRIThere are multilevel various sized soft tissue lesions on thoracic vertebral bodies including T3, T5, T8, T9, T10, T11, T12, L1 and L2. Left side T8, T9, T10, T11 and T12 ribs also show soft tissue lesion involvement. Especially at the level of T10, there is evidence of soft tissue extension from the left side rib toward pleura.The T10 vertebral body shows about 10% of compression fracture.There is normal thoracic kyphosis and the alignment is anatomic. The cord signal is normal. The conus medullaris terminates at the level of T12-L1.
1. Multilevel metastatic lesions involving both cervical and thoracic level as well as left lower ribs. In particular, at the level of C3 and C4, the lesion involves and encasing left side neural foramen and transverse foramen. There is also pleural extension of metastatic rib lesion at the level of T10.2. There is about 10% of compression fracture of T10 vertebral body. 3. Spinal cord signal intensity remains normal. 