Clinical question: Evidence of malignancy. Signs and symptoms: Patient with focal area of enhancement in right C6 vertebrae which enhances. CT of the cervical spine:Examination demonstrate a lytic lesion in the right superior aspect of C7 vertebrae. There is thinning of the cortex posteriorly and at the level the superior endplate of T1 however without any break/defect of the cortex.Finding correspond to the previously noted enhancing focus in C7 on prior MRI exam. Possibility of malignancy should be considered. There is no evidence of fracture or malalignment. There is also no evidence of any additional foci of cystic change of the column.Limited images through the skull base are also negative.The alignment the vertebral column is within normal.
1.There is an osseous lytic lesion within the superior right lateral aspect of T7 vertebrae corresponding to the region of enhancement noted on prior MRI. This lesion measures approximately 12 x 8 x 8-mm in size. There is no evidence of extension of the lesion into the cortex and no evidence of fracture. Possibility of malignancy should be considered till proven otherwise.2.Negative nonenhanced CT of cervical spine otherwise.