Male, 52 years old, with metastatic thyroid cancer, follow-up exam. Thoracic:An enhancing lesion within the left aspect of the T5 vertebral body continues to measure approximately 13 x 9 mm and shows no significant interval change from the prior exam. Lesions within the left transverse process and pars interarticularis of T5 and T6 are also unchanged.Anterior instrumented fusion of T10-T12 is again seen with partial corpectomy at T11 and placement of a strut graft. The residual T11 vertebral body continues to show diffuse abnormal marrow signal without significant change. Kyphotic angulation of the thoracic spine is seen centered at T11.No new marrow space lesions are seen. No significant epidural disease is suspected. No significant spinal canal stenosis is seen.Fatty marrow replacement in the lower thoracic spine likely represents postradiation change. Failure of fat suppression is also seen in the lower thoracic spine on postcontrast fat-suppressed images.Lumbar:Enhancing lesions on the right at L2, on the left at L3, and on the left at L5 show no significant interval change. For reference, the L5 lesion continues to measure 18 x 16 mm.The background marrow remains fatty replaced compatible with prior radiation. No new lesions are seen. No significant epidural disease extension is detected. The spinal canal remains patent.Facet hypertrophy develops at lower lumbar levels becoming severe at L4-5. There is a bulging disc at L4-5 with a right far lateral annular fissure, unchanged. There is a bulging disc at L5-S1 with a small central protrusion, unchanged.
Stable scattered metastatic lesions in the thoracic and lumbar spine with no evidence to suggest any new or growing metastatic disease.