Malignant neoplasm of esophagus, unspecified [C15.9], Reason for Study: ^Reason: esophageal CA with L1 soft tissue met and new LLE pain/weakness History: new LLE pain/weakness For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There is an enhancing intramuscular lesion at the level of L1,32.9mm (CC) x 14.5mm (AP) x 22.2mm (RL) indicating metastatic lesion.There is about 17.8mm sized subcutaneous well circumscribed lesion without evidence of enhancement but with evidence of suppression on fat suppression scan. This is more likely represent fat containing benign lesion such as focal fat necrosis or inclusion cyst.There is no evidence of vertebral body metastasis.There are multifocal Schmorl's nodes at the level of L4 and L5 vertebral bodies with degenerative changes.The disc height of L45 is decreased indicating disc degeneration.The vertebral body height is preserved. The signal of the visualized cord is normal. The conus medullaris terminates at the T12-L1 level. Degenerative changes are specified by the intervertebral level as follows: T12-L1: Disc desiccation, no neuroforaminal narrowing or spinal stenosis. L1-L2: Disc desiccation, no neuroforaminal narrowing or spinal stenosis. L2-L3: Mild to moderate spinal canal stenosis due to disc bulging with bilateral ligamentum flavum thickening. No neuroforaminal narrowing or spinal stenosis. L3-L4: Disc desiccation with disc degeneration decreased disc height. No neuroforaminal narrowing or spinal stenosis. L4-L5: Disc desiccation, diffuse bulging of disc. No neuroforaminal narrowing or spinal stenosis. L5-S1: no neuroforaminal narrowing or spinal stenosis.
1. Left paraspinal muscle intramuscular metastatic lesion as described above.2. No evidence of vertebral body metastatic lesion.3. Multifocal disc degenerations especially at the level of L34 and L45 with the Schmorl's malformation as described above.4. Mild spinal canal stenosis at the level of L23.