Metastatic T8 spine lesion. Status post resection and stabilization. Evaluate for residual tumor or abnormality. The examination is limited at the operative levels by susceptibility artifact related to the metallic hardware.The vertebral bodies are preserved in height. There is desiccation and moderate height loss involving C5-C6 and C6-C7 discs. The disc-osteophyte complexes at C5-C6 and C6-C7 result in mild spinal canal narrowing. There are changes of previous partial, right-sided T8 corpectomy and costotransversectomy, complete T8 and partial T7 laminectomies. The associated hardware (interbody spacer at partial T8 corpectomy site as well as dual posterior rods and the bilateral pedicle screws at T6, T7, T9 and T10) are better depicted on the companion CT scan. The artifact related to the hardware partially obscures the fused segments. The lobulated soft tissue mass at the corpectomy level, which also involves the remaining part of T8 vertebra, does circumferentially encase and mildly narrow the thecal sac resulting in near complete obliteration of the CSF extending from the mid T7 level to the inferior T8 level. However, there is minimal, if any, deformity of the spinal cord. It is difficult to assess the spinal cord for signal abnormality. The soft tissue mass also effaces the T7-T8 and T8-T9 neural foramina bilaterally and abut the posterior wall of the adjacent aorta. The new T11 central/anterior vertebral body compression and the progressed T10 at the inferior endplate fracture are associated with mild subjacent marrow edema but no gross replacement of marrow. This is associated with intervertebral and intervertebral gas, as evident on the CT scan. There is no retropulsion at this level. There is no compression or significant marrow signal abnormality at the other thoracic levels.STIR/T2-hyperintense, contrast enhancing lesion involving the L2 vertebral body may represent a hemangioma though not completely assessed on this examination.There are postoperative findings in the overlying back soft tissues at midline but no drainable fluid collection. There is dilatation of the renal collecting systems, likely a combination of mild hydronephrosis and extrarenal pelvises. This is probably related to the known large pelvic mass.
1.The examination is limited at the operative levels by susceptibility artifact related to the metallic hardware.2.Postoperative findings related to tumor resection, spinal canal decompression, partial T8 corpectomy, and T6-T10 fusion. Hardware better depicted on the comparison CT scan from the same day.3.Destructive soft tissue mass centered at the T8 corpectomy level with epidural extension narrows the thecal sac, from mid T7 to the inferior T8 level, but does not appear to cause frank cord compression. If there is high clinical suspicion of residual cord compression, CT myelogram may be considered.4.There is a new T11 and worsened T10 vertebral body compression fracture since the CT scan from February 7, 2016 with mild associated edema. 5.L2 vertebral body lesion is not completely assessed but may represent a hemangioma.