Leptomeningeal metastases in the spine
Work-up in patient with known breast carcinoma.
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Multiple vertebral bodies return abnormal marrow signal consistent with the known history of diffuse skeletal metastases. The levels involved are; L3, T1, T2, T3 and T9. Normal vertebral body heights. The cauda equina roots are markedly thickened and demonstrate marked nodular enhancement extending from the level of the conus down to the sacrum consistent with leptomeningeal spread. Extensive nodular enhancement is demonstrated along the dural surface of the entire thoracic cord. Mild increased T2 signal seen diffusely within the thoracic cord.
Conclusion: Extensive leptomeningeal disease coating the thoracic cord and roots of the cauda equina with mild spinal cord oedema. Metastatic deposits within a number of vertebral bodies.