Back pain. History of breast carcinoma. Lytic lesions in the vertebral body of L1 levels are seen, correlating with abnormalities seen on prior MRI. The lesion at L1 involves both anterior and posterior elements. There is pathological fracture of L1, with retropulsion and epidural mass causing spinal canal stenosis. These findings are better seen on the prior MRI study. In addition, there are also lytic lesions involving the right transverse process, pedicle and facet of L4, extending into the right neural foramen. There are multiple lesions in bilateral iliac bones.There is no evidence of kyphoplasty changes in the lumbar spine. The uterus appears bulky, with calcifications.There is a 4 mm hypodense lesion at the inferior pole of the left kidney, too small to categorize.
1. Lytic lesions in multiple vertebral levels and pelvis, consistent with metastasis. Pathological fracture of L1 with epidural mass, causing compromise of the spinal canal.2. Bulky uterus with calcifications, which may be secondary to fibroids. Please correlate with pelvic ultrasound if clinically indicated.3. Small hyperdense left renal lesion, too small to characterize. This may represent a small hyperdense cyst, and can correlated with ultrasound.