Female, 48 years old, with history of left parotid cancer status post surgery. Assess for recurrence. Pain and numbness in the right shoulder. History of cervical spine surgery. Cervical spine:Evidence of instrumented anterior fusion is again seen from C4 through C6 similar to prior. The cervical lordosis is straightened, but the alignment is otherwise unremarkable. Vertebral body heights are preserved. No concerning marrow signal abnormality is seen. No pathologic enhancement is detected. The visualized spinal cord is unremarkable except as discussed below.C2-3: Unremarkable. C3-4: Mild facet hypertrophy. Posterior disc-osteophyte complex formation. Mild to moderate spinal canal narrowing slight flattening of the ventral cord. Mild right foraminal narrowing. No interval changes. C4-5: Left paracentral osteophytic spurring causing slight flattening of the ventral cord and mild generalized spinal canal stenosis. No significant foraminal narrowing. No interval changes. C5-6: Left paracentral osteophytic spurring with minimal spinal canal narrowing and no significant cord impingement. No significant foraminal narrowing. No interval changes. C6-7: Broad disc osteophyte complex resulting in a mild to moderate spinal canal stenosis. Moderate to severe left and moderate right foraminal narrowing. No interval changes. C7-T1: Unremarkable. Evidence of left parotidectomy is discussed more fully below.Neck soft tissue:Sequelae of left parotidectomy is seen with minimal residual parotid tissue. Scarring and volume loss are noted. No evidence of nodular or masslike soft tissue or worrisome enhancement is seen in the operative bed.The remaining salivary glands are unremarkable. No pathologic adenopathy is detected in the neck by size criteria. Two or three subcentimeter T2 hyperintense nodules are evident within the left thyroid lobe. There may be a 1 cm heterogeneous nodule along the posterior aspect of the right thyroid lobe.
1.Redemonstration of postoperative findings in the cervical spine without significant interval change.2.Scattered mild to moderate cervical degenerative disease is unchanged.3.Redemonstration of sequelae of left parotidectomy. No evidence to suggest recurrent primary tumor is seen. No pathologic adenopathy is detected in the neck.4.No other specific findings are seen to account for the patient's right-sided symptoms.5.Nonspecific thyroid nodules are seen for which dedicated ultrasound assessment can be considered as clinically warranted.