 Diffuse osseous metastases is seen throughout the cervical, thoracic and lumbar spine, with metastases seen at nearly all levels of the thoracic and lumbar spine. Vertebral bodies are nearly completely replaced by tumor at the C4, T6, T7, T10, T11 and L5 levels. Tumor involvement causes moderate spinal canal stenosis at the C3-C4, T6-T7 and the T10-T11 levels. There is thickening of the anterior epidural space at the C4 and T7 levels, suspicious for epidural extension of tumor. Increased size of soft tissue metastasis posterior to the sacrum is also noted.Grade 1 retrolisthesis of L5 on S1. Alignment is otherwise within normal limits. Vertebral body heights are within normal limits. Severe disc degeneration with loss of disc height is seen at the L4-5 and L5-S1 levels.
This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. Diffuse osseous metastases is present throughout the cervical, thoracic and lumbar spine. There is suspicion for thickening of the anterior epidural space at the C4 and T7 levels, suspicious for epidural extension of tumor. Consider MRI of the cervical and thoracic spines with contrast for further evaluation.Findings were discussed with PA Anderson at 11:45 AM on 12/21/2016.