Reason: please evaluate schwannoma in right brachial plexus and see if there is also a tumor on the left History: man with NF2 who is said to have tumor of both right and left brachial plexi. Limited images of the brain show bilateral enhancing lesions centered in the CP angles and IACs, right greater than left, likely vestibular schwannomas. There are additional enhancing lesions, anterior to the cerebellum as seen on coronal views as well as a lesion posteriorly within the foramen magnum which measures 1.6 x 1.5 cm (5/14). There are bilateral enhancing lesions around the C1-C2 thecal sac, right greater than left, causing no significant thecal sac compromise.There is minimal anterolisthesis of C4 on C5 and retrolisthesis of C6 on C7. Vertebral body heights are maintained. Multilevel disc desiccation without significant disc space loss. No abnormal marrow signal. Two small enhancing lesions are seen within the cord at C1-C2 which are suspicious for tumor.C2-C3: Enhancing left nerve root with mild expansion of the neural foramina likely represents a schwannoma. No spinal canal narrowing.C3-C4: No enhancing lesions. No spinal or neuroforaminal stenosis. C4-C5: Large enhancing lesion originating within the spinal canal causing expansion of the right neural foramina measuring 1.5 cm in width, similar to the prior exam. Small left extraforaminal lesion is unchanged. Lesion causes severe narrowing of the canal and deformity of the cord. C5-C6: Large, predominantly extraforaminal lesion on the right measuring up to 1.5 cm a second thickness, unchanged. Small enhancing extra foraminal lesion on the left is likely unchanged. No spinal canal stenosis.C6-C7: Small, predominantly extraforaminal enhancing lesions bilaterally without expansion of the foramina are likely unchanged. No spinal canal stenosis.C7-T1: Small predominantly enhancing extraforaminal enhancing bilaterally lesions without expansion of the foramina, likely unchanged. No spinal canal stenosis.Additional smaller schwannomas partially visualized within the thoracic spine.
1.Multiple schwannomas bilaterally throughout the cervical spine, the largest lesions on the right at C4-C5 and C5-C6, are overall unchanged from the prior exam. The lesion at C4-C5 causes severe spinal canal narrowing and deformity of the cord, similar to the prior exam.2.Two small enhancing lesions within the cord at C1-C2 are unchanged from the prior exam and likely represent a primary cord neoplasm.3.Multiple additional intracranial schwannomas partially visualized, including bilateral acoustic schwannomas.