Large soft tissue nodule in midline posterior neck, likely lipoma. Evaluate for infiltration in the spinal column. Patient has a limited neck range of motion. There is a 1.7x2.7x4.1 cm (APxTRVxcraniocaudal) lobulated well-circumscribed T1 hyperintense lesion involving the left paramedian neck subcutaneous soft tissues with low signal on the fat suppressed sequences consistent with lipoma. No deep invasion into the paraspinous musculature or spinal canal is seen, as clinically questioned.There are no other abnormal masses or evidence of pathologic enhancement in the neck. There are scattered subcentimeter lymph nodes which are nonspecific. No pathologically enlarged or necrotic lymph nodes are seen. The airway remains patent. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. No suspicion osseous lesions are seen. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.Dedicated cervical spine MRI was not obtained, however, there is evidence of congenital narrowing of the spinal canal with superimposed degenerative changes including mild disk bulge at C3-C4, which partially effaces the ventral and dorsal thecal sac, as well as a relatively larger disk bulge at C5-C6 which effaces the left greater than right ventral thecal sac. No evidence of frank cord compression.
1. Superficial lipoma involving the left paramedian subcutaneous neck soft tissues. No deep extension into the paraspinous musculature or spinal canal, as questioned. 2. Congenital narrowing of the cervical spinal canal with superimposed mild degenerative changes. There is mild to moderate spinal canal stenosis at C5-C6 related to disk bulge.