Weakness, neck pain, evaluate for cord compression. There is an approximately 5.2 x 4.3 x 5.7 cm enhancing mass involving the posterior and right lateral elements of C3-C6. A portion of the mass extends into the epidural space and compresses the posterior cervical spinal cord. Anteriorly at C5-C6, the spinal cord is compressed against a large posterior disc osteophyte complex and there is high T2 signal in the spinal cord in this region. Additionally, there is a 4.0 x 4.4 x 7.1 cm mildly enhancing mass in the posterior mediastinum involving the esophagus. More inferiorly there appears to be a partially imaged mass and/or hiatal hernia. There is enhancement involving the C5 and C6 vertebral bodies. The thoracic spinal cord is unremarkable and there are no tumors in the thoracic or lumbar vertebrae. There is no spondylolisthesis or significant loss of vertebral body height. There are a few minimal posterior disc-osteophyte complexes in the thoracic spine and there is incompletely characterized degenerative spondylosis in the lower lumbar spine.
1. A large mass involving the posterior and right lateral elements of C3-C6 with epidural extension and associated compression of the spinal cord with edema in conjunction with a prominent disc-osteophyte complex at C5-6. The tumor appears to also involve the C5 and C6 vertebral bodies and may represent metastatic disease.2. A bulky mass involving the mid esophagus and posterior mediastinum, as well as partially imaged mass and/or hiatal hernia may represent the primary tumor and/or additional metastatic disease. Dedicated chest CT or PET may be useful for further evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.