 There are multiple metastatic lesions within the cervical and thoracic vertebral column. In particular, there has been interval increase in size of the lesions within the C2 through C4, and C7, where there is now epidural extension into the right spinal canal that results in mild spinal canal stenosis, but no spinal cord compression. However, there is obliteration of the right C2-3 neural foramen by the tumor. Nevertheless, the vertebral body heights are preserved. There are an unchanged probable hemangioma in the T1 and T2 vertebral bodies. There is unchanged loss of the usual cervical lordosis. There is degenerative spondylosis with minimal spinal canal stenosis at C3-4, C4-5, and C6-7, mild left neural foraminal stenosis at C3-4, mild-to-moderate right neural foraminal stenosis at C4-5, severe left and moderate right neural foraminal stenosis at C6-7, and mild right neural foraminal stenosis at C7-T1. There is a probable Thornwaldt cyst, which is unchanged.THORACIC SPINE
1.Post-operative and post-radiation treatment findings in the spine with overall increase in the vertebral metastases in the cervical spine and in T1 through T5 and T9. The tumor involving the T6 through T8 vertebrae appears similar, although precise comparison is limited due to the presence of hardware artifacts and there still appears to be severe spinal canal stenosis with compression of the spinal cord. 2.Interval decrease in the marrow signal and tumor enhancement in the lower lumbosacral spine related to radiation treatment.3.An unchanged subcentimeter lesion in the cauda equina nerve roots at the L3 level may represent a peripheral nerve sheath tumor.4. Interval increase in size of an upper mediastinal lymph node metastasis.5. Unchanged degenerative spondylopyosis in the cervical spine and lower lumbar spine.