Multiple myeloma. Further assessment of epidural mass. Study is mildly to moderately limited by patient motion.The posterior epidural mass that extends from C6-C7 level to the mid T5 level shows intense, solid contrast enhancement, confirming its solid nature. . The abnormal contrast enhancement in fact extends craniocaudally beyond the mass on the noncontrast MRI but this may include a dural tail; from mid C6 to mid T6 level. The mass is more pronounced on the left side where it wraps and extends through the neural foramina and seems to be incongruity with the previously described left paraspinal mass at the T2 and T3 levels; specifically through the T3-T4 neural foramen. The mass does also invade the left posterior-lateral aspect of the T3 vertebral body/pedicle. In the axial plane, the paraspinal mass measures at mid T3 level 4.3 cm x 2.7 cm (including the T3 osseous invasion). The left neural foraminal involvement extends from C7-T1 through T4-T5.As described previously, the mass causes spinal cord compression with subtle increase of the cord T2-signal at the compressed segment. The spinal canal otherwise preserved; small anterior indentations by degenerative disc/endplate disease most pronounced at T6-T7 through T8-T9 cause no significant spinal canal narrowing.
1.The solid contrast enhancement in the left posterior epidural mass involving the cervicothoracic spine confirms its solid nature. The mass extends through the left-sided neural foramina and is contiguous with the left paraspinal mass described previously.2.The mass causes compression of the spinal cord with subtly increased T2 signal.