Locoregional synovial sarcoma of spine (C2-T2) with cardiac extension; pulmonary relapse March 2016; surveillance imaging. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild scattered paranasal sinus mucosal thickening. There is also a mild effusion within the left mastoid air cells.Spine: There are postoperative findings related to C2-T2 laminoplasty and tumor debulking. There is interval decrease in size of the enhancing left paraspinal tumor with encasement of the left vertebral artery at these levels, with invasion of each neural foramen and minimal extension into the intraspinal epidural space, measuring up to 20 mm in thickness at the C3-4 level, previously 25 mm. There is persistent patchy heterogeneous marrow replacement throughout the cervical spine and upper thoracic spine, but the vertebral body heights are preserved. There is a kyphotic curvature at the cervico-thoracic junction, but no spondylolisthesis. The spinal canal is narrowed from C3-C7, which is in part attributable to kyphotic curvature, a tight laminoplasty and small posterior disc-osteophyte complexes. There is associated mild spinal cord flattening in this region, without spinal cord signal abnormality. The posterior paraspinal tissues are unchanged. There are nodules within the partially imaged right lung. There is a small right apical pneumothorax.
1. Slight interval decrease in size of the treated residual tumor along the 2. Persistent patchy heterogeneous marrow replacement throughout the cervical spine and upper thoracic spine, but the vertebral body heights are preserved. 3. The spinal canal is narrowed from C3-C7, which is in part attributable to kyphotic curvature, a tight laminoplasty and small posterior disc-osteophyte complexes. 4. No evidence of intracranial metastases.5. Pulmonary metastases and small right apical pneumothorax. Please refer to the separate chest CT report for additional details.