Evaluate for progression of metastatic disease. Images through the skull base and including cavernous sinuses remain free of malignancy. Paranasal sinuses and mastoid air cells are unremarkable.Images through the soft tissues of the neck demonstrate a cluster of large nonenhancing mass is in the left supraclavicular region. The transverse diameter of this cluster of tumors measures 21-mm x 40 3-mm on axial image 74. On coronal reformatted image 37 the cranial cervical and the transverse axises of the tumor measures 40-mm. There are no prior examinations for comparison. There is evidence of mass effect and medial deviation of the left common carotid artery and left internal jugular vein by the cluster of nodes. There is no evidence of bony destruction with this finding.Metastatic lesion to vertebral body of C6 with near complete collapse of vertebrae and enhancing extra osseous extension of tumor into the ventral epidural space is noted. Sagittal reformatted images demonstrate mass effect and deviation of the cord posteriorly. Metastatic lesion to the posterior body of C7 also demonstrates epidural extension of tumor into the ventral epidural space. No compression deformity of C7 is detected. These findings can be further evaluated with a dedicated MRI of the spine. No evidence of any additional osseous metastases in the area of exam is identified.Limited images of the apices of the lungs demonstrates extensive scarring (left greater than right). A non-calcific nodule measuring approximately 7 mm times 15-mm is identified in the posterior aspect of right upper lung field (axial image 94). No mediastinal lymphadenopathy is detected.
1.Cluster of metastatic nodes in the left supraclavicular region as detailed above.2.Metastatic lesion to C6 with significant compression deformity and metastatic lesion to the posterior aspect of C7 vertebrae. There is extraosseous epidural spread of tumor at this level into the cervical spinal canal.3.Metastatic nodule in the right upper lung field.4.Mass-effect and posterior deviation of the cord at C6 is noted. This area can be further evaluated with a dedicated MRI of spine.5.No prior examinations from this institution for comparison.