Thoracic spine pain. Compared to prior CT chest of 8/17/2011, there has been slight interval progression of diffuse metastatic disease involving the thoracic spine, from T1 to T8 levels. For example, there is increased lytic lesion at T2 level. There is involvement of both anterior and posterior columns. There is soft tissue mass component of the spine metastasis, with epidural components extending into the spinal canal and neural foramina, with likely impingement of spinal cord and exiting nerves. These findings can be further characterized with MRI.There is compression fracture of T6 and T4 levels, which appears unchanged. Endplate depression of T5 is also noted, and also appears unchanged.Rib metastasis is present.There is tortuous thoracic aorta, with atherosclerotic changes.
1. Progression of diffuse metastatic disease in the thoracic spine, with epidural components that likely result in spinal cord and nerve impingement. Correlation with MRI thoracic spine is recommended.2. Pathological compression fractures at T4, T5, and T6 levels, not significantly changed. No evidence of new fracture.3. Rib metastasis. Please correlate with CT chest.