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Fig. 4E. 41-year-old patient with multiple myeloma of C1/C2, status post posterior spinal fusion, chemotherapy, and bone marrow transplant 9 months ago. Sagittal fat-suppressed T1-weighted MRI with gadopentetate dimeglumine, obtained 7 months later for alteration in blood parameters that was suspicious for recurrent tumor. There is abnormal enhancing soft tissue at C1/C2 (arrow) that was thought to represent recurrent tumor.