Male, 24 years old, history of testicular cancer with a thoracic metastasis. Findings are redemonstrated compatible with prior laminectomy and intraspinal tumor debulking from T9-10 through T11-12. The postoperative soft tissues are diffusely enhancing compatible with scarring/granulation, and there is 10 x 4 x 2 cm fluid collection within the subcutaneous operative bed. This collection does not reach to the dural margin, though at the T11-12 level, there is a discontiguous small locule of fluid immediately dorsal to the dura.Minimal ventral epidural thickening at T9, contiguous with enhancing disease in the vertebral body, is improved from prior. Likewise, minimal epidural thickening, contiguous with adjacent marrow space disease, at T11 is also improved. At no point in the operative region is there any large or bulky epidural disease, nor any significant spinal canal stenosis or cord compression.No evidence of epidural or marrow space disease is seen in the cervical or upper thoracic regions. Patchy enhancement within the T9 and T11 vertebral bodies is more focal and less uniform than on the prior study. The T11 vertebral body continues to show mild anterior wedging similar to prior.The lumbar spinal canal is congenitally narrow, but no evidence of significant epidural tumor is seen.Fairly diffuse enhancement persists within the L1 vertebral body and right pedicle with some heterogeneity centrally. The L4 vertebral body shows evidence of marrow replacement but no discrete enhancement. The L5 vertebral body shows a small region of enhancement on the right, although the entire vertebral body shows marrow replacement. The S1 vertebral body shows irregular but fairly diffuse enhancement. Patchy enhancement within the iliac wings is partially visualized.Since the prior examination, partially visualized pulmonary and mediastinal masses have significantly decreased in size.
1.Redemonstrated are findings related to surgical debulking of tumor from T9 through T12. The posterior soft tissue operative bed shows evidence of scarring/granulation, and there is a subcutaneous fluid collection which most likely represents a seroma.2.Only minimal ventral epidural thickening is seen at T9 and T11, contiguous with enhancing disease within the respective vertebral bodies. At no point is there any bulky epidural disease, significant canal stenosis or cord compression.3.Marrow space disease in the lower thoracic and lumbar spine has changed in imaging appearance, perhaps representing response to therapy. No evidence of new or progressive bony disease is seen.4.Partially visualized mediastinal and lung masses also seem to have decreased significantly in size.