 Brain: There are several enhancing lesions in the skull. For example, the largest in the right frontal calvarium measures up to approximately 20 mm. There are associated defects in the cortex, but no mass effect upon the underlying brain. There is no evidence of intraparenchymal mass lesions. However, there is diffuse cerebral white matter T2 hyperintensity and a chronic lacunar infarct in the right pons. There is no evidence of intracranial hemorrhage or acute cerebral infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact.Cervical spine: There are multiple enhancing lesions in the cervical spine and upper thoracic spine. In particular, there is epidural extension of tumor involving the C3 and C4 vertebrae with negligible spinal canal stenosis, but substantial encroachment upon the neural foramina at those levels. There is no evidence of spinal cord compression or signal abnormality. There is mild endplate deformity of several cervical vertebral bodies, which may represent pathologic fractures. There is underlying multilevel degenerative spondylosis, which is most pronounced at C5-6, with mild spinal canal stenosis.
Multiple metastases involving the imaged axial skeleton without evidence of metastatic lesions in the brain parenchyma or spinal cord compression.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.