Malignant neoplasm of unspecified site of right female breast [C50.911], Reason for Study: For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There multifocal bone marrow replacing lesions seen on T12, L2, L3, L4, L5, and S1 vertebral bodies which are consistent with metastatic lesions. In particular, L5 vertebral body shows about 20% of height loss with bone marrow edema indicating acute/subacute compression fracture. There is no evidence of retropulsion of the fracture fragment at this level.Bilateral iliac bones also demonstrate multiple bony lesions consistent with metastatic lesions. There is normal lumbar lordosis. The spine alignment is anatomic. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing. The conus medullaris terminates at the T12-L1 level. The paraspinal soft tissues are unremarkable.Diffuse bulging of intervertebral disc is seen at the level of L45, otherwise lumbar intervertebral discs are unremarkable.
1. Multiple bony metastasis involving lumbar spine, sacrum and bilateral iliac bones.2. About 20% pathologic compression fracture of the L5 vertebral body with bone marrow edema as described above.