Clinical question: Newly diagnosed germinoma. Signs and symptoms: Evaluate disease status. Pre- and post enhanced cervical MRI:Examination demonstrates no detectable metastatic lesion to the cervical spine, cord or developed meninges.There is normal anatomical alignment of the vertebral column however mild reversal of cervical lordosis centered at C4-C5 level.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 is unremarkable.C4-C5 demonstrate mild bulging disc and unremarkable otherwise.C5-C6 demonstrate a tiny linear enhancement within the annulus of the disc highly suggestive of an annular fissure. No spinal stenosis or neural foraminal compromise.C6-C7 is unremarkable.C7-T1 is unremarkable.Incidental note is made of a tiny cystlike lesion in the superior aspect of nasopharynx in the midline measuring approximately at 5 mm in size and highly suggestive of a Thornwaldt cyst.Pre and post enhanced thoracic MRI:There is normal signal intensity and alignment of vertebral column.There is normal signal intensity and caliber of the thoracic cord.There is no evidence of spinal stenosis or neural foraminal compromise at any level.There is no detectable abnormal enhancement of the cord, leptomeninges or the vertebral column.Pre- and post enhanced lumbar MRI:There is normal signal intensity and caliber of the lower most visualized thoracic cord, conus and the cauda equina without detectable abnormal enhancement.There is normal signal intensity and alignment of vertebral column without abnormal enhancement.No evidence of a spinal stenosis or neural foraminal compromise at any level.
1.Pre- and post enhanced MRI of cervical spine demonstrate no detectable metastatic lesions. There is a small midline enhancing annular fissure at C5-C6, mild reversal of cervical lordosis at C4-C5. Incidental note is made of a 5 mm Thornwaldt cyst.2.Unremarkable pre and post enhanced thoracic MRI.3.Unremarkable pre and post enhanced lumbar MRI.