Female, 51 years old, with history of metastatic ovarian cancer presenting with progressive upper back pain. Evaluate for cord compression, impending fracture. Complete marrow replacement of the C5, C6, C7 and T1 vertebral bodies is demonstrated. A small focal marrow replacing lesion is also present within the C4 vertebral body. Mild ventral epidural extension of disease is evident at C5 and C6, contributing to spinal canal narrowing at C5 but no frank cord compression. The T1 vertebral body bows posteriorly which also contributes to mild spinal canal narrowing, but again no compression is seen.Near complete marrow replacement of the T8 vertebral body is seen with mild posterior bowing. No evidence of epidural spread or cord compression is seen. An additional smaller lesion is seen within the T7 vertebral body. Subcentimeter foci of enhancement within the T9 and T12 vertebral bodies are nonspecific. No definite evidence of metastatic disease is seen in the lumbar spine.The visualized spinal cord demonstrates normal morphology and signal intensity throughout. No evidence of pathologic intramedullary or leptomeningeal enhancement is seen.Spinal alignment is anatomic. Vertebral body heights are maintained. Mild degenerative findings are seen in the cervical region without any associated spinal canal or foraminal compromise. No significant degenerative findings are evident in the thoracic region. In the lumbar spine, there is loss of disc height, endplate degenerative signal change and mild disc bulging at L5-S1 with mild bilateral foraminal narrowing but no significant spinal canal stenosis.Multiple enlarged lymph nodes are seen within the lower neck, the mediastinum, and intra-abdominal. Patchy opacification is also seen at the right lung base. A subcentimeter nodule is demonstrated in the right upper lobe.
Multiple metastatic lesions are evident within the cervical and thoracic vertebral bodies. At C5 and C6, there is mild ventral epidural disease involvement which results in mild spinal canal stenosis at C5 but no cord compression. At T1, and to a lesser extent at T8, posterior bowing of vertebral body results in mild spinal canal narrowing, but again there is no evidence of cord compression.No definite evidence of metastatic disease is seen in the lumbar region. No definite evidence of intrathecal disease is noted. Extensive adenopathy is incidentally visualized in the neck, mediastinum and abdomen.