Age: 53
Sex: Female
Indication: Low back pain and concern for meningitis, history of breast cancer
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Case #21
Findings
- Multifocal nodular enhancement along nerve roots of the cauda equina with enhancing material layering in the caudal thecal sac at the level of S2
- Thin linear enhancement along the surface of the conus and visualized lower thoracic spinal cord
- Enhancement and mild T2 signal hyperintensity within lateral right erector spinae muscle fibers
- Mild retrolisthesis at L5-S1
- Advanced disc dessication and height loss at L5-S1 and otherwise mild multilevel degenerative changes without significant spinal canal or neural foraminal stenosis
- Conus terminates at L1-L2, in normal position
- Normal marrow signal
Diagnosis
- Leptomeningeal metastatic disease
Sample Report
Multifocal nodular enhancement along nerve roots of the cauda equina with enhancing material layering in the caudal thecal sac at the level of S2 and thin linear enhancement along the surface of the conus and visualized lower thoracic spinal cord, concerning for extensive leptomeningeal metastatic disease.
No acute osseous findings or evidence of osseous metastatic disease.
Enhancement and mild T2 signal hyperintensity within lateral right erector spinae muscle fibers is nonspecific, but may represent denervation atrophy.
Multilevel degenerative changes, most advanced at L5-S1, without significant spinal canal or neural foraminal stenosis.
Discussion
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