Metastatic colon cancer, neck pain radiating. Is there metastatic disease? There is evidence of osseous metastatic disease with diffuse low T1 marrow signal, STIR hyperintensity, and enhancement involving the C5 vertebral body, as well as the right posterior aspect of the T3 vertebral body, pedicle, and transverse process extending into the right posterior third rib. Motion degradation limits evaluation for small lesions; there are tiny foci of T1 hypointensity and enhancement involving the C2 and C3 levels which are favored to represent vascular structures and less likely metastatic foci. Please note bone scan or PET may better assess the burden of osseous metastatic disease. There is no evidence of epidural tumor in the cervical spine. Vertebral body heights are normal. There is minimal retrolisthesis of C4 on C5. Alignment is otherwise grossly maintained.Degenerative changes are evident as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Disc osteophyte complex. Minimal spinal canal narrowing. No significant neural foraminal stenosis.C4-5: Central disc osteophyte complex. Minimal spinal canal narrowing. Mild right and minimal left neural foraminal narrowing.C5-6: Left paracentral disc osteophyte complex and ligamentum flavum thickening with mild spinal canal stenosis. Mild narrowing of the neural foramina bilaterally related to uncovertebral hypertrophy.C6-7: Small disc osteophyte complex and uncovertebral hypertrophy. No significant spinal canal stenosis. Mild left neural foraminal narrowing. No significant right neural foraminal narrowing.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Lung masses related to known metastasis noted and better assessed on recent chest CT. There is long segment enhancement involving the esophageal wall.
1. Edema and enhancement involving the C5 vertebral body likely related to metastatic disease. There is also a larger destructive metastatic lesion involving the right posterior aspect of the T3 vertebral body extending into the posterior elements and third rib which was also noted on chest CT from 11/9/2015.2. No evidence of epidural tumor or pathologic fracture in the cervical spine. There are mild degenerative changes involving the cervical spine from the C3-C4 to the C6-C7 levels with mild spinal canal and mild multilevel neural foraminal stenosis. Please see details above. 3. Long segment enhancement is noted involving the esophageal wall/mucosa which may represent treatment-related esophagitis.