Sagittal (above left) and axial (above right) CT without contrast of the cervical spine shows an expansile lytic lesion with a thin margin in the spinous and transverse processes of the T1 vertebral body. There is marked anterolisthesis of T1 on T2. Sagittal T2 MRI without contrast of the cervical spine (below left) shows the anterolisthesis at T1 and T2 causing extreme cord compression while an axial T2 MRI obtained at this level (below right) shows a fluid-fluid level in the lesion to the anterior and right of the vertebral body.
