Bilateral lower extremity pain. History of metastatic lung cancer. Thoracic Spine: There is no evidence of fracture. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. There are partially imaged postoperative findings related to right lower lobectomy.Lumbar Spine: There is an enhancing mass in the right aspect of the thecal sac at the L5 level, which measures up to 12 mm in length. There may also be a small amount of enhancing tumor on the left side of the thecal sac at this level. There appears to be engorgement of the surrounding venous structures at this level as well. In conjunction with mild disc bulging, facet hypertrophy, and ligamentum flavum thickening, there is severe spinal canal stenosis at L4-5. There is also mild bilateral neural foraminal narrowing at L4-5 and L5-S1. There is no significant spinal canal or neural foraminal stenosis at the other levels of the lumbar spine. A punctate focus of enhancement in the left posterolateral spinal canal at the level of L3-4 along the length of a vessel may represent focal dilatation of the vessel. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved, aside from multilevel small intravertebral disc herniations. The vertebral bone marrow signal is unremarkable. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.
Enhancing tumor in the right aspect of the thecal sac, and perhaps also in the left aspect of the thecal sac at the L5 level may represent metastatic disease or peripheral nerve sheath tumor for example. In conjunction with mild disc bulging, facet hypertrophy, and ligamentum flavum thickening, there is severe spinal canal stenosis at L4-5. 