36-year-old male with history of metastatic renal cell cancer with back pain.EXAM: CT of the thoracic and lumbar spine was performed without IV contrast. Thoracic spine: Alignment of thoracic spine is normal. Mild degenerative changes are seen throughout the thoracic spine. No lesions suspicious for metastases are identified. Nodular opacities at the right lung base are likely due to previously identified consolidation.Lumbar spine:3.3 x 2.9 cm lucent lesion in the L3 vertebral body, with a sclerotic rim, is not significantly changed compared to CT pelvis study from 2/18/08. There is a suggestion of posterior extension of this lesion into the central canal, however, this is equivocal. Additionally, another lucent lesion measuring 1.5 x 0.8 cm in the L1 vertebral body with sclerotic borders is identified. Although these lesions have a benign appearance the etiology of these lesions is unknown, and further evaluation by infused MRI is recommended.
Two lucent lesions in the lumbar vertebral bodies as described above. Extension of the L3 lesion posteriorly into the central canal cannot be excluded. Although they have a benign appearance, the etiology of these lesions is unknown. Further evaluation by contrast-enhanced MRI is recommended.