Spinal tumor

Spinal tumors are neoplasms located in either the vertebral column or the spinal cord.[1] There are three main types of spinal tumors classified based on their location: extradural and intradural (intradural-intramedullary and intradural-extramedullary). Extradural tumors are located outside the dura mater lining and are most commonly metastatic.[2] Intradural tumors are located inside the dura mater lining and are further subdivided into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the dura and spinal cord parenchyma, while intradural-extramedullary tumors are located within the dura but outside the spinal cord parenchyma. The most common presenting symptom of spinal tumors is nocturnal back pain.[1] Other common symptoms include muscle weakness, sensory loss, and difficulty walking.[1] Loss of bowel and bladder control may occur during the later stages of the disease.[3]

The cause of spinal tumors is unknown. Most extradural tumors are metastatic commonly from breast, prostate, lung, and kidney cancer.[4] There are many genetic factors associated with intradural tumors, most commonly neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2), and Von-Hippel Lindau (VHL) syndrome.[1] The most common type of intradural-extramedullary tumors are meningiomas and nerve-sheath tumors.[5] The most common type of intradural-intramedullary tumors are ependymomas and astrocytomas.[6] Diagnosis involves a complete medical evaluation followed by imaging with a CT or MRI. A biopsy may be obtained in certain cases to categorize the lesion if the diagnosis is uncertain.[1][4][5]

Treatment often involves some combination of surgery, radiation, and chemotherapy.[1][4][5] Observation with follow-up imaging may be an option for small, benign lesions.[4] Steroids may also be given before surgery in cases of significant cord compression.[1] Outcomes depend on a number of factors including whether the tumor is benign or malignant, primary or metastatic, and location of the tumor. Treatment is often palliative for the vast majority of metastatic tumors.[5]

  1. ^ a b c d e f g Spinal cord tumors. Arnautović, Kenan I.,, Gokaslan, Ziya L. Cham, Switzerland. 2018. ISBN 978-3-319-99438-3. OCLC 1084270205.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: others (link)
  2. ^ Gossman, William; Hoang, Stanley; Mesfin, Fassil B. (2019), "Cancer, Intramedullary Spinal Cord Tumors", StatPearls, StatPearls Publishing, PMID 28723060, retrieved 2019-12-03
  3. ^ Balériaux, D. L. F. (1999-08-01). "Spinal cord tumors". European Radiology. 9 (7): 1252–1258. doi:10.1007/s003300050831. ISSN 1432-1084. PMID 10460357. S2CID 6586168.
  4. ^ a b c d Burton, Matthew R.; Mesfin, Fassil B. (2019), "Cancer, Conus And Cauda Equina Tumors", StatPearls, StatPearls Publishing, PMID 28722908, retrieved 2019-12-03
  5. ^ a b c d "Spinal Tumors – Types, Symptoms, Diagnosis and Treatment". www.aans.org. Retrieved 2019-12-03.
  6. ^ Mechtler, Laszlo L.; Nandigam, Kaveer (2013-02-01). "Spinal Cord Tumors: New Views and Future Directions". Neurologic Clinics. Spinal Cord Diseases. 31 (1): 241–268. doi:10.1016/j.ncl.2012.09.011. ISSN 0733-8619. PMID 23186903.