Metastatic esophageal cancer and left lower extremity weakness.. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild diffuse cerebral volume loss. There is trace nonspecific periventricular white matter T2 hyperintensity. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, and scalp soft tissues are grossly unremarkable. There are mild secretions in the anterior left ethmoid sinus. There is a subcentimeter retention cyst in the right lateral nasopharyngeal recess. There are bilateral lens implants.Cervical Spine: There is fusion of the C3 through C6 vertebral body with loss of the usual kyphosis and bony projection into the spinal canal C3-4 and C5-6 with mild indentation of the spinal cord at C3-4. There are also disc-osteophyte complexes and prominent facet joint hypertrophy at C2-3, right greater than left, and at C7-T1. There is mild left C2-3, severe left C3-4, moderate left C4 though C6, severe right C2 though C6, and bilateral moderate C7-T1 neural foraminal stenosis. There are foci of high T2 signal in the grey matter bilaterally and associated mild volume loss in the spinal cord at the C5 level. However, there is no evidence of mass lesions in the cervical spine and the vertebral bone marrow appears unremarkable.
1. No evidence of intracranial metastases or acute infarction.2. Fusion of the C3 through C6 vertebral body, multilevel neural foraminal stenosis, moderate spinal canal stenosis at C3-4, and myelomalacia at C5, but no evidence of cervical spine metastases.