Diagnosis: Malignant neoplasm of tongue, unspecified site. Malignant neoplasm of soft palate. Malignant neoplasm of retromolar area. Secondary malignant neoplasm of bone and bone marrowClinical question: h/o HNC, CRT, and bone mets, compare to previous, measurements please There is redemonstration of a 55 mm superior-inferior length x 9 mm thickness x 38 mm AP dimension mass centered at the T7 and T8 vertebral body levels which is anterior lateral to the right aspect of these vertebral bodies. It previously measured 55 mm superior-inferior length 37 mm and AP dimension and 8 mm in thickness.From C1 down to T3 the marrow signal within the spine is high signal. From T4 through T12 is predominantly low signal on T1-weighted imaging with the exception of T11 which is predominantly high signal but heterogeneous. On postcontrast imaging there is redemonstration of an enhancing lesion within the T10 vertebral body measuring 20 mm in one in the T11 vertebral body measuring 11 mm. Within the T9 vertebral body measures 9 mm one in the T8 vertebral body measures 17 mm one in the T7 vertebral body measures 6 mm smaller lesions are present at T5,T4 and T3. Compared to the prior exam lesions have not changed in size.The cystic lesion present within subcutaneous lesions at the level of the T6 spinous process which most likely represents a sebaceous cyst.The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots.
1.There is a right anterolateral paraspinous lesion centered at the T7 and T8 vertebral body levels which is minimally larger on the current exam when compared to the prior exam.2.There are multiple lesions scattered throughout the thoracic spine which are stable in dimensions when compared to the prior exam.3.There is no compromise of thoracic spinal cord or spinal canal identified.