Malignant neoplasm of right ciliary body [C69.41] / Malignant melanoma of skin, unspecified [C43.9], Reason for Study: ^Reason: METASTATIC MELANOMA , lesion identified to thoracolumbar spine area, initial staging to determine tx options. History: HX melanoma. There are multiple enhancing lesions at T10 and L4 vertebral bodies which show ill defined high signal intensity on T2 and low signal intensity on T1 indicating possible metastatic lesions.Similar lesions (low T1, ill defined high T2 and peripheral enhancement on post Gad T1) are seen on the right ilium (series 24, image 34) and the right side ala of S1(series 24, image 37). Another two smaller lesions are seen on the left side ilium (series 24, image 37).Relatively well defined vertebral body lesions with high T1 and high T2 with enhancement at T6, T9, and L3 bodies are likely represent vertebral hemangiomas.T1 low, T2 high with enhancement at T11 and T12 endplates could represent disc degeneration related endplate change but cannot completely exclude possibility of metastatic lesion.There is normal thoracic kyphosis and lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The signal of the visualized cord is normal. The conus medullaris terminates at the T12-L1 level.There is no evidence of abnormal enhancement of spinal cord, there is no evidence of cord compression or mass. Degenerative changes are specified by the intervertebral level as follows: Diffuse bulging of discs with abuts thecal sac at the level of T10-11 and T11-12. There is no evidence of spinal canal stenosis or neuroforaminal stenosis.T12-L1: Minimal bulging of disc. No neuroforaminal narrowing or spinal stenosis. L1-L2: Minimal bulging of disc. No neuroforaminal narrowing or spinal stenosis. L2-L3: Diffuse bulging of disc with associated with bilateral ligamentum flavum thickening result in bilateral lateral recess minimal stenosis. No spinal stenosis. L3-L4: Broad-based disc protrusion which abuts thecal sac in association with bilateral ligamentum flavum thickening result moderate spinal canal stenosis.L4-L5: Diffuse bulging of disc with bilateral ligamentum flavum thickening causing moderate spinal canal stenosis at this level. L5-S1: Diffuse bulging of disc. No spinal stenosis.
1. Multiple metastatic lesions involving T10 and L4 including right S1 ala as well as bilateral ilium.2. Degenerative spinal stenosis at the level of L3-4, and L4-5.3. No evidence of spinal cord compression, abnormal signal intensity of spinal cord, nor abnormal enhancement.