Female, 26 years old, with history of biphenotypic liver tumor, HCC/cholangiocarcinoma, with bone metastases and back pain. Assess metastatic disease at T11-12 as seen on CT. An enhancing mass is present centered on the left aspect of the T12 vertebral body and pedicle measuring up to 34 x 31 mm in the axial plane. The lesion extends into the left ventral epidural space causing mild encroachment upon the thecal sac. The lesion also extends mildly into the left lateral paraspinal soft tissues. The neural foramen is not significantly compromised. The remaining marrow space of the T12 vertebral body is edematous and enhancing which may be reactive to the tumor.No other discrete osseous lesions are seen in the thoracic spine. Spinal alignment is anatomic. Vertebral body heights are preserved. The spinal cord shows normal signal intensity and morphology. No pathologic intrathecal enhancement is noted. The intervertebral discs are normal.Numerous pulmonary nodules are partially visualized. The left lobe of the liver is enlarged and heterogeneous likely indicating tumor involvement.
An osseous metastasis is seen affecting the left aspect of the T12 vertebral body and pedicle. This lesion encroaches upon the left ventral epidural space causing mild thecal sac narrowing but no significant spinal canal stenosis or compression of the spinal cord or nerve roots.