31-year-old with history of breast cancer presenting with lower extremity weakness. Cord abnormality noted on prior MRI. Redemonstration of widespread osseous metastatic disease throughout the visualized spine. There are multiple compression deformities throughout the thoracic spine most notably at T3, T9, and T11 with at most 50 percent loss of vertebral body height, but without significant retropulsion of the fracture fragments. There is mild increase in the thoracic kyphosis centered around T3 compression deformity. Alignment is otherwise maintained.There is extensive enhancing tumor in the paraspinal soft tissues which becomes confluent from T3 to T8. There is filling of the neural foramen at these levels with tumor. There is also extensive multilevel extension into the ventral epidural space which creates at most mild spinal canal stenosis. Redemonstration of a focal intramedullary signal abnormality in the thoracic cord at the T12-11-1 level. There is increased T2 signal as well as slight expansion of the cord. Postcontrast images show a 6 x 4 x 6 mm focus of enhancement as well as extensive deposits noted along the visualized cord.Note is made of multiple expansile rib metastases and associated right pleural effusion.
1.Focus of expansile intramedullary enhancement and increased T2 signal in the spinal cord at the T12-L1 level compatible with an intramedullary metastasis.2.Numerous drop metastases along the visualized thoracic spinal cord.3.Widespread osseous metastatic disease appears similar to prior studies. There are numerous stable compression deformities without significant fragment retropulsion.4.Widespread paraspinal tumor enhancement with multilevel neural foraminal/epidural extension creating at most mild spinal canal stenosis.