Male, 53 years old, with thyroid cancer metastatic to the thoracic lumbar spine, on therapy evaluation. Also with hypermetabolic lymph node in the neck on PET scan. Neck:Evidence of total thyroidectomy is seen. No suspicious soft tissue lesions are demonstrated in the thyroidectomy bed. Scattered small lymph nodes are present in the neck but none of these meets imaging criteria for pathologic enlargement. The aerodigestive mucosa is unremarkable. The right submandibular gland has likely been resected. The remaining salivary glands are unremarkable. The aerodigestive mucosa is free of any masslike lesion.Thoracic spine:An enhancing lesion within the T5 vertebral body is unchanged measuring approximately 13 x 8 mm in the axial plane. Enhancing slightly expansile lesions within the left transverse process and pars interarticularis of T5 and T6 are also unchanged. Postsurgical findings are redemonstrated from T10 to T12 including left lateral fusion and partial corpectomy of T11. The residual T11 vertebral body continues to show diffuse marrow replacement and enhancement. A mild kyphotic deformity centered at T11 is unchanged. Fatty replacement of the marrow in the lower thoracic spine is redemonstrated compatible with prior radiation. No new lesions are identified.Lumbar spine:Enhancing lesions are redemonstrated within the L2, L3 and L5 vertebral bodies. No significant interval change in size is noted. The reference L5 lesion continues to measure 18 x 16 mm in the axial plane.Fatty replacement of the vertebral body marrow is again seen compatible with prior radiation. No new lesions are detected. Mild degenerative findings are stable and unchanged with no areas of significant spinal canal or foraminal stenosis.
1.Evidence of thyroidectomy is seen with no lesions in the neck suspicious for recurrent tumor or pathologic adenopathy.2.Stable metastatic lesions in the thoracic and lumbar spine. No new osseous lesions are identified.