Malignant neoplasm of unspecified part of left bronchus or lung [C34.92] / Secondary malignant neoplasm of unspecified site [C79.9], Reason for Study: ^Reason: location and extent of spinal mets from met lung CA and any cord compression History: severe p Brain MRIThere are multiple scattered abnormal signal intensity lesions on skull including right parietotemporal area (series #1001, image #19/32) and left frontal area (series #1001, image #21/32), slightly increased in size of the lesions since prior scan.Since there was no post contrast images, intraparenchymal nodular enhancement cannot be evaluated, however, there is no evidence of space-occupying lesion or abnormal edema. Right C2 lesion is again seen, appears to be slightly increased since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.No change of right maxillary sinus retention cyst.Cervical Spine MRIThere is signal change of the C2 dens indicating infiltrative process. In addition, the right side body of the C2 shows 19.5mm x19.9mm x 25.6mm soft tissue mass. The lateral margin of the mass abuts right C2 neural foramen.At the level of T1-2, there are upper mediastinal right side paratracheal lymph nodes and left pleural effusion. Comparing to prior Chest CT scan, no significant interval change since prior scan.Spinal cord signal intensity is normal.Vertebral body alignment is normal with normal lordosis.Thoracic Spine MRIThere is about 10% compression fracture T11 vertebral body with disruption of anterior cortical margin. There is another small vertebral body lesion at T9 vertebral body close to its superior endplate.Spinal cord signal intensity is normal.There is no evidence of spinal canal stenosis.Thoracic neural foramen appear to be normal.
1. Interval increase in size of multiple skull metastasis and possibly C2 lesion since prior scan.2. No evidence of acute ischemic or hemorrhagic lesion.3. No evidence of brain parenchymal metastasis.4. C2 body right side metastatic mass as well as about 10% compression fracture of T11 metastasis lesion. 5. Focal metastatic lesion at T9 vertebral body superior endplate.6. No evidence of spinal cord compression, no spinal canal stenosis. 7. No abnormal spinal cord signal intensity.