Patient with history of poorly differentiated carcinoma of liver with known lytic lesion at T12, evaluate for other spinal lesions . Patient complaining of back and abdomen pain. Cervical Spine: There is a punctate focus of fat signal in the C7 vertebral body, which is suggestive of a hemangioma or focal fat deposition. There is no spondylolisthesis. The vertebral body and disc space heights are preserved. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.Thoracic Spine: There are expansile tumors arising from the medial right third rib and sternum. There is also a lesion within the T12 vertebral body with extension of tumor into the epidural space, which has increased in size and associated with mild indentation of the spinal cord and severe left neural foraminal stenosis. There is no discernible signal abnormality in the spinal cord. There is also mild loss of height of the T12 vertebral body. There is also mild T6 superior endplate deformity, without evidence of underlying tumor. Otherwise, the alignment is anatomic. There are bilateral pleural effusions, ascites, and multiple bilateral lung and liver lesions.Lumbar Spine: There are small foci of T1 hypointensity and T2 hyperintensity, demonstrating enhancement in the L1 vertebral body. The lumbar vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.
1. Metastatic disease progression involving the axial skeleton, including a right third rib lesion, a sternal lesions, a T12 vertebral lesion with associated mild spinal cord indentation and severe left neural foraminal compromise, and a small lesions in the L1 vertebral body2. Numerous liver and lung metastatic lesions, as well as ascites and pleural effusions, are partially imaged. Please refer to the prior body CT for additional details.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.