Female, 58 years old, follow-up examination status post C5 anterior corpectomy for tumor resection, history of lung cancer. Cervical:Findings are redemonstrated compatible with anterior corpectomy of C5 with anterior instrumented fusion of C4-C6.Bulky residual tumor involving the C5 paraspinal and ventral epidural spaces is again seen. The largest component is in the right paraspinal region and measures 33 x 19 mm, previously 31 x 18 mm. The ventral epidural component has mildly thickened now resulting in constriction of the spinal canal to 8 mm AP, with a previous caliber of 10 mm AP.Tumor in the left paraspinal space at C5 is also slightly bulkier compared to prior. Paraspinal tumor encroaches upon the C4-5 and C5-6 neural foramina bilaterally. Paraspinal tumor also abuts the vertebral arteries bilaterally with partial encasement on the right.No new lesions are detected in the cervical spine. No other areas of significant spinal canal or foraminal narrowing are suspected.Thoracic:A severe compression deformity of the T5 vertebral body is again seen with complete tumor infiltration and retropulsion into the ventral epidural and right posterior lateral paraspinal spaces. The spinal canal is severely narrowed and the cord is compressed but with no evidence of spinal cord edema. The size of the tumor and the degree of spinal canal narrowing and cord impingement are unchanged from prior. The right T5-6 neural foramen is severely encroached by tumor.A moderate compression of the T8 vertebral body with tumor infiltration of the anterior aspect is again seen appearing similar to the prior examination. No epidural extension is seen and the spinal cord and canal are not compromised.No additional or new osseous lesions are detected. Elsewhere the spinal canal and neural foramina are not significantly narrowed. The spinal cord is free of pathologic signal change and enhancement.A mass is partially visualized in the left lung apex.
1.Demonstration of postoperative findings related to anterior C5 corpectomy as well as anterior instrumented fusion of C4-C6.2.Interval growth of tumor is seen in the C5 paraspinal and ventral epidural spaces. The spinal canal at C5 is further encroached by this growing epidural tumor.3.Stable metastatic involvement of the T5 vertebral body with a significant compression deformity and significant epidural and paraspinal tumor extension. The degree of spinal canal narrowing and cord impingement at T5 are unchanged.4.Stable metastatic involvement of the T8 vertebral body with no significant spinal canal compromise.5.No new metastatic lesions are seen in the cervical or thoracic spine.