Neoplasm related pain (acute) (chronic) [338.3] / Malignant neoplasm of anterior two-thirds of tongue, part unspecified [141.4], Reason for Study: ^Reason: is there metastatic cancer in the lower cervical spine History: pain and numbness in ulnar distribution. There are multiple bone marrow signal replacing lesions including C2 odontoid process, C2 body and T1 vertebral bodies with enhancement indicating metastatic lesion.In addition, there are soft tissue masses with diffuse enhancement on the right C12 neural foramen, right C7T1 and right T1-T2 neural foramen as well as adjacent C6, C7 transverse process indicating metastatic lesion.There is normal cervical lordosis. The cervical spine alignment is anatomic. The signal of the visualized cord is normal. There is no evidence of cord compression.Degenerative changes are specified by the intervertebral level as follows: C2-C3: diffuse enhancement of bilateral neural foramen with indistinct nerve root sleeves indicate possible metastatic infiltration. No spinal stenosis. C3-C4: no neuroforaminal narrowing or spinal stenosis. C4-C5: no neuroforaminal narrowing or spinal stenosis. C5-C6: ligamentum flavum thickening with minimal bulging of disc and disc dessication, however, no neuroforaminal narrowing or spinal stenosis. C6-C7: no neuroforaminal narrowing or spinal stenosis. C7-T1: Soft tissue mass on the right neural foramen which obliterates neural foraminal fat indicating metastatic soft tissue lesion, no neuroforaminal narrowing or spinal stenosis.
1. Multifocal normal bone marrow signal replacing lesions including C2, C6, C7 and T1 as described above.2. Soft tissue mass lesions on the neural foramen of C23 bilateral, C7TT1 right and T1T2 right neural foramen.3. Spinal cord signal intensity appears to be normal. No cord compression. 