Malignant neoplasm of long bones of lower limb [170.7], Reason for Study: ^Reason: 30 yo F with Ewing sarcoma of R femur with met to retroperitoneum p/w fever, neutropenia, and headache, s/p Vincristine, doxorubicin, and cyclophosphamide chemo. No evidence of acute ischemic or hemorrhagic lesion on this scan.There is no abnormal enhancement.There is about 4.7mm cerebellar tonsilar herniation through the foramen magnum.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of acute ischemic or hemorrhagic lesion.2. No abnormal enhancement. No intracranial mass.3. About 4.7mm cerebellar tonsilar herniation through foramen magnum as described above.