Procedure: MRI LUMBAR SPINE WWODiagnosis: Malignant neoplasm of spinal cordClinical question: eval s/p lumbar tumor removalSigns and Symptoms: same Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. Since the prior exam the patient is undergone right-sided hemilaminectomy at the L3 vertebral body level for removal of an intrathecal mass.. There is some central and to lesser degree peripheral clumping of nerve roots present at the L3-4 disc space level at the prior location of the patient's intrathecal mass. This associated with some contrast enhancement. There is a small fluid collection present at the hemilaminectomy site measuring approximately 16 x 11 mm axial dimensions. There is associated fluid in the subcutaneous tissues superficial to the paravertebral muscles at the incision site.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is a 27 x 28 mm axial dimension mass at the inferior pole of the left kidney which also be identified on the recent abdomen CT from 10/29/2015.
1.Since the prior exam from 3 weeks ago , the patient is undergone surgery for removal of an intrathecal mass. Some clumping of nerve roots at the level of the mass is concerning for potential arachnoiditis.2.There is a fluid collection present at the surgical site could simply represent postsurgical fluid.3.There is a mass at the inferior pole of the left kidney which can also be identified on the recent CT of the abdomen. Please refer to the CT of the abdomen for further comments. The possibility this represents a neoplasm cannot be excluded.