 The patient's lytic defect involving the right anterior mandibular body has better osseous characterization on the recent CT. Within the lytic defect proper, the MRI demonstrates ill-defined T2 hyperintensity and enhancement which extends into adjacent soft tissues. A central masslike portion measures 20 x 14 mm in axial dimension, yet signal and enhancement abnormality extends beyond this. There is an adjacent right-sided 14 x 10 mm rounded enhancing submandibular lymph node. A previously described small lucency within the left fibular condyle also demonstrates enhancement and T2 hyperintensity, which may indicate another myelomatous lesion, especially given the lack of degenerative findings of the left TMJ. The remainder of the mandible demonstrates a benign marrow signal.Redemonstrated is a left torus mandibularis. Previously identified lucencies within the cervical spine, particularly anterior aspects of the C4 and C5 vertebral bodies, are not well characterized on the current study given MRI face acquisition technique, although there is a suggestion of enhancement on the sagittal THRIVE sequence at these aforementioned levels.Minimal sporadic mucosal thickening in the paranasal sinuses is again noted. Redemonstrated are intraocular lens implants and a right scleral buckle.
1.Within a right anterior mandibular lytic defect, there is ill-defined T2 hyperintensity and enhancement which extends into adjacent soft tissues. A central masslike portion measures 20 x 14 mm in axial dimension, yet signal and enhancement abnormality extends beyond this. 2.There is an adjacent right-sided 14 x 10 mm rounded enhancing submandibular lymph node. 3.A lesion within the left mandible condyle is suspicious for a myelomatous lesion.4.There are findings suggestive that C4 and C5 lytic lesions identified on CT demonstrate enhancement. However, these are not well characterized on the current study given MRI face acquisition technique.