C2 lesion, colon cancer with metastases to spine. Six-month follow-up. 7 mL of IV MultiHance was administered, 3 mL discarded. Again seen is T1 shortening involving the C1-C3 vertebral bodies consistent with prior radiation therapy. There is no abnormal edema or enhancement at these levels to suggest residual or recurrent tumor. There remain multiple abnormal foci of enhancement and T2/STIR hyperintensity involving the C3, C4, C5, C6, C7, T1, and T2 vertebral bodies consistent with known metastatic disease. There is mild interval enlargement of the lesions compared to study from 5/28/2015. For example round enhancing lesion involving the C4 vertebral body measuring 9 x 11 mm in the AP and craniocaudal dimensions previously measured 8 x 9 mm. Enhancing C7 spinous process lesion previously measuring 4 mm in the AP dimension, now measures 8 mm. There is also increased marrow infiltration of the left T3 lamina as noted on the sagittal images.Vertebral body heights and alignment are grossly unchanged including straightening and minimal anterolisthesis at the C7-T1 level similar to prior. There remains at least moderate spinal canal stenosis at the C3-C4 level related to prominent disc osteophyte complex and ligamentum flavum thickening and not significantly changed. Minimal enhancement along the anterior dura at this level is likely degenerative in etiology. There is T2 hyperintensity and volume loss consistent with myomalacia at the C3-C4 level also unchanged. Minimal spinal canal stenosis at the C7-T1 level related to disc bulge also appears similar.No evidence of epidural tumor. No abnormal leptomeningeal or intramedullary enhancement.
1. Posttreatment changes involving the cervical vertebral bodies from C1 to C3 without gross evidence of residual or recurrent tumor at these levels. 2. Continued enlargement of metastatic lesions involving the cervical spine more inferiorly and upper thoracic spine as detailed above. No evidence of pathologic fracture or epidural tumor.3. Moderate spinal canal stenosis at the C3-C4 level on a degenerative basis with cord myelomalacia is unchanged.