Male, 30 years old, history of Ewing's sarcoma. Prior cryoablation resulting in paralysis. Evaluate for progression. Compared to 4/9/2015, there is slight decrease in enhancement associated with lesion involving the dorsal and superior aspect of the T12 vertebral body. The area of enhancement measures approximately 17 x 13 mm in the sagittal plane compared to 21 x 14 mm measured similarly; component of enhancement (which is favored to represent the edema component) is decreased, with the lesion itself measuring approximately 11 mm and not significantly changed. Small enhancing lesion involving posterior superior aspect of the T3 vertebral bodies is not significantly changed, measuring approximately 11 x 8 mm and previously also 11 x 8 mm. Again seen is the sequelae of prior ablation and cement placement within the T10 vertebral body. This includes bilateral transpedicular access tracts and low signal centrally within the vertebral body related to the presence of cement. There is abnormal STIR signal and enhancement involving this vertebral body extending into the pedicles similar to prior. Again seen is atrophy of the spinal cord at the T10 level. The cord seems to be retracted anteriorly towards the vertebral body as seen before. Again seen is nodular enhancement along the anterior aspect of the cord at this level. Abnormal T2 signal involves the central cord bilaterally as well as ventrally slightly more inferiorly at T10.No new enhancing lesions are appreciated. No evidence of epidural tumor. There is minimal depression involving the superior endplate of the T10 vertebral body similar to prior. Vertebral body heights are otherwise maintained. Alignment is maintained. No significant spinal canal stenosis or neural foraminal narrowing is detected.
1. Compared to 4/9/2015, there is no evidence of metastatic disease progression. Previously treated enhancing T10 vertebral lesion is not significantly changed. Enhancing T3 lesion is not significantly changed. T12 vertebral body lesion demonstrates slight decrease in surrounding edema and enhancement which may suggest treatment response. No new lesions.2. Sequela of prior cryoablation related injury to the thoracic cord with mild cord atrophy and ventral cord enhancement at T10.