Diagnosis: Secondary malignant neoplasm of other parts of nervous systemClinical question: eval grade II astrocytoma.Signs and Symptoms: grade II astrocytoma.Comments: Grade II astrocytoma s/p bx and RT. Now on TMZ. | Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The marrow signal is hyperintense on T1 suggestive of prior radiation treatment. Patient is status post cervical spine surgery with laminectomies at C5 and C6.There is a T2 hyperintense mass within the spinal cord extending from the C3-4 disc space level down to the C7 vertebral body level measuring 46 x 11 mm in sagittal dimensions which is eccentric towards the right hemicord. It previously measured 44 x 10 mm in sagittal dimensions. Greatest axial dimensions at the C5-6 level are currently 15 x 12 mm and previously were 14 x 11 mm.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.MRI thoracic spine:There is redemonstration of a T2 hyperintense mass within the thoracic spinal cord centered within the left hemicord measuring approximately 109 mm in length which extends from the T2-3 level to the T8 vertebral level. It previously measured similar length. It measures 11 x 9 mm in greatest axial dimensions at the T4-5 level and has not changed since the prior exam.The thoracic vertebral bodies are appropriate in the overall alignment and height. There are marrow signal changes present along the posterior aspect of the thoracic vertebral bodies with hyperintense T1 signal.
1.The intra-axial thoracic spinal cord mass is stable compared to the prior exam. This is known to represent astrocytoma.2.There is slight increase in the size of the patient's cervical thoracic spinal cord intra-axial mass. This is known to represent astrocytoma.3.Status post cervical spine surgery4.Marrow signal changes in the visualized thoracic and cervical spinal cord is likely due to prior radiation treatment