Malignant neoplasm of vertebral column [C41.2], Reason for Study: ^Reason: hx L3 chordoma with hx of resection. Eval for recurrence or abnormality History: surveillance imaging For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. External fixation with pedicular screws and rods from L1 to L5 with L3 colpectomy and instrument inserted at the level of L3.There are significant metallic artifacts from L1 to L5 instrumentations.There are diffuse enhancement on the L3 colpectomy area with mesial aspects of adjacent bilateral psoas muscles which most likely represent postop scar tissue. There is no definitive mass formation or abnormal enhancing soft tissues is seen.There is relatively well delineated lenticular shaped lesion on the L3 level posterior to spinal canal with some peripheral enhancement. The lesion shows high signal intensity on T2 and low signal intensity on T1 indicating fluid content. There is no evidence of mass effects against spinal canal.There is thin walled tubular lesion on the right side of the thoracoabdominal aorta. The lesion is about 22.8mm (AP) x 26.8mm (RL) x 55.3mm (CC). Comparing to prior scan especially Abdominal CT scan obtained on Jan 28 2015, the lesion is most likely representing evolving paraaortic retroperitoneal hematoma. Visualized spinal cord appears to be normal in signal intensity and conus medullaris terminates at L1 level. There is no other abnormal enhancement or lesion.Previously seen right renal cyst is again shown, no change since prior scan.
1. Post L3 colpectomy with external fixation from L1 to L5.2. No evidence of abnormal enhancement on this scan.3. Diffuse enhancement of L3 colpectomy area including mesial aspect of bilateral psoas muscles indicating post-surgical scar tissues. No definitive evidence of enhancing mass on operation site.4. Evolving retroperitoneal para aortic hematoma.5. Fluid collection which located posterior aspect of the spinal canal without showing any evidence of mass effects toward spinal canal with mild peripheral enhancement. Likely represent post surgical fluid collection.