There is a destructive lytic metastatic lesion involving almost the entire vertebral body of L1, extending into the pedicles, right worse than left, and into the right transverse process. It is associated with a pathologic compression fracture which demonstrates a maximum height loss of 55%. The lesion is causing cortical and endplate destruction.There is bulging of the mass to the spinal canal with soft tissue extension into the epidural space anteriorly and laterally causing severe central canal stenosis. There is also extraosseous soft tissue infiltration into the right paravertebral tissues and into the T12-L1 and L1-L2 neural foramen bilaterally, worse on the right. This is resulting in severe neural foraminal stenosis at L1-L2 on the right.
A left sided nephrectomy, pancreatic metastasis and retroperitoneal lymphadenopathy are noted.