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The entire cord appears expanded with increased central T2 signal and prominence of the central canal. There is a thick rind of enhancement around the cord post administration of contrast. In addition, there is clumping and enhancement within the cauda equina and nerve roots in the lumbar thecal sac.
Pulmonary metastasis and mediastinal lymph nodes are also noted.
Brain: (not shown)
There has been resection of two of the cerebellar lesions. Once again there are innumerable enhancing intra-axial lesions evident, numbering at least 20. Since prior examination, many of the lesions have increased in size. There is surrounding vasogenic oedema.
No brainstem lesions are identified but there is cord signal abnormality at the cervicomedullary junction. There is also new finding of abnormal meningeal enhancement in the posterior fossa, particularly marked around the brainstem and within the sylvian fissures.