Clinical question: 55-year-old female with colon cancer, on chemotherapy. Signs and symptoms: Complains of cervical and thoracic pain.? Bone metastases. Pre-and post-enhanced cervical MRI:Examination demonstrate no evidence of osseous metastatic lesion of the cervical spine.The signal intensity of the vertebral column is unremarkable. There is normal anatomical alignment of cervical spine. Unremarkable images at the level of foramen magnum and no evidence of central spinal stenosis at any level. No convincing evidence of neural foraminal compromise at any level. Minimal degenerative disease at C2-- C4 is noted.There is normal signal intensity and caliber of cervical cord without abnormal enhancement.Pre-and post-enhanced thoracic MRI:Examination demonstrates a large loculated primarily T2/T2 stir hyperintense mass in the dorsal aspect of the spinal canal extending from approximately T2 -- T3 disk level inferiorly to mid T9 level. There is faint patchy and linear enhancement of the cystic lesion which is highly suspected for a cystic metastatic lesion. There is mass effect and anterior displacement of the cord along the length of this tumor however without detectable edema or abnormal enhancement of the cord. This finding however results in central spinal stenosis throughout this region. The lesion demonstrates partial fixation and resultant expansion of the right neural foramina at T4 -- T5, bilateral neural foramina at T5 -- T6, bilateral neural foramina at T6 -- T7 and right neural foraminal T7 -- T8 levels.The signal intensity and alignment the vertebral column remains within normal and without detectable abnormal enhancement to suggest metastatic disease.
1.Pre-and post-enhanced MRI of the cervical spine demonstrate no evidence of osseous, leptomeningeal or cord metastatic disease. Minimal degenerative changes without central spinal stenosis or neural foramina compromise.2.Pre-and post-enhanced MRI of thoracic spine demonstrate an intracanalicular extramedullary cystic loculated rim enhancing mass posteriorly extending from T2 to T9 levels highly suggestive of a cystic metastatic lesion as detailed above. There is mass effect and forward displacement of the cord and central spinal stenosis at these levels. Unremarkable pre-and post enhanced thoracic MRI otherwise. Please see detailed report above.