75-year-old male with metastatic renal cell carcinoma.. There is redemonstration of a lesion centered in the right pedicle and lamina of the T6 vertebra, measuring up to 3.7 cm in greatest dimension. There is expansion of the lamina with effacement of the right posterior lateral epidural space and likely minimal adjacent epidural extension of the tumor at the T6 level. There is slight involvement of the posterior aspect of the T6 vertebral body, right sixth rib and right paraspinal soft tissues. The overall spinal canal is mildly narrowed without significant mass effect on the spinal cord. Mild right neural foraminal narrowing is also present at T6-T7. There are no additional enhancing lesions identified in the thoracic spine. Bone marrow signal abnormality from the endplates at T10-T11 are felt to reflect degenerative changes. The vertebral column alignment is within normal limits. The vertebral body and disc heights are preserved. The spinal cord displays normal signal and morphology. There are multiple enlarged hilar lymph nodes bilaterally and a few scattered pulmonary nodules nodules, which are better evaluated on prior CT of the chest. The left kidney is not visualized.
1. Expansile lesion in the right posterior elements of T6 with associated effacement of the right posterior lateral epidural space with violation of the cortex and likely minimal adjacent epidural extension. No significant mass effect on the spinal cord. No additional enhancing osseous lesion identified in the thoracic spine.2. Numerous enlarged intrathoracic lymph nodes and lung lesions, better evaluated on prior CT of the chest.