Neuroblastoma with relapse x 2; progression of disease. Extensive diffuse marrow abnormality is seen in the bilateral frontal bones with probable extension into the bilateral parietal bones. Exact extent of tumor is best evaluated with MRI, if clinically indicated. There is a thick band of epidural enhancement in the bifrontal region which measures 7 mm in maximum dimension consistent with epidural spread of tumor (best seen image 15-22). There is minimal mass effect on the superior sagittal sinus which is mildly displaced posteriorly. There is no evidence of intraparenchymal mass or edema. No abnormal leptomeningeal enhancement is seen. The ventricles and basal cisterns are normal in size and configuration.The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Extensive marrow abnormality in the bilateral frontal bones, probably extending to the bilateral parietal bones consistent with osseous metastases. Thick band of epidural enhancement in the bifrontal region consistent with epidural spread of tumor. Extent of disease may be better evaluated with MRI, if indicated clinically. 