PMC9195113_01
There is heterogeneity of marrow signal with multiple foci of STIR hyperintensity and enhancement compatible with diffuse osseous metastases (yellow arrow). There is a probable pathologic compression fracture of the L5 vertebral body with concavity of the superior and inferior endplates and marrow edema (green arrow). There is nodular enhancement along the conus medullaris in the leptomeninges compatible with leptomeningeal carcinomatosis (red arrow). There is a fusiform mass along the right L3-4 neural foramen, along the bilateral L4-5 neural foramen, bilateral L5-S1 neural foramen and along the S1 to S3 neural foramen bilaterally with enhancement (red arrow). There is also enhancement along the T12-L1, L1-2 and L2-3 neural foramen.
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A CT scan of the chest, abdomen, and pelvis was unremarkable, without any evidence of adenopathy, ascites, or inflammatory changes (see Fig. 1).