Malignant neoplasm of pelvis [C76.3] / Personal history of antineoplastic chemotherapy [Z92.21], Reason for Study: ^Reason: history of sacral teratoma (recurrent), treated with resection, chemotherapy and radiation. History: worsening back pain Subtle enhancing areas of the soft tissue at the level of lower sacral area indicating postoperative scar changes which are not completely included with current scan. In addition, comparing to outside MRI scan performed on July 2, 2016, the low signal intensity lesion around the left obturator foramen is not covered either.Therefore, this scan needs to be repeated without additional charge for complete evaluation of the postoperative status of sacrococcygeal lesion (known as teratoma).For the purpose of this dictation, the vertebral body demonstrates costochondral junction is labeled T12. Inhomogeneous MR signal intensities of sacrum and bilateral iliac bones may represent post radiation changes. There is no evidence of associated soft tissue mass. There is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing. The conus medullaris terminates at the T12-L1 level. There is no evidence of abnormal enhancement, cord compression or mass. Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: no neuroforaminal narrowing or spinal stenosis. 10mm sized vertebral body hemangioma is seen. L2-L3: no neuroforaminal narrowing or spinal stenosis. L3-L4: no neuroforaminal narrowing or spinal stenosis. L4-L5: no neuroforaminal narrowing or spinal stenosis. L5-S1: Minimal bulging of disc, disc dessication. No neuroforaminal narrowing or spinal stenosis.
1. The scan is incomplete and not include the left sacrococcygeal lesion seen on outside scan. Thus, needs to be repeated.2. Inhomogeneous bone marrow signal intensity of sacrum and bilateral iliac bones indicate postradiation changes.3. No evidence of soft tissue mass on this scan.4. Spinal cord signal intensity is normal.