Spinal cord tumours

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Spinal cord tumours are classified based on their location.

They are subdivided into:

• Intramedullary tumours
• Intradural extramedullary tumours
• Extradural extramedullary tumours

Intramedullary tumours

Intramedullary tumours are very rare tumours that develop inside the parenchyma of the spinal cord, and damages the latter. In most cases, these are gliomas, especially ependymomas (in 45% of cases) and astrocytomas (in 35% of cases). They are rarely hemangioblastomas, which can occur in people who have Von Hippel Lindau disease.

Ependymoma is a neoplasm that develops mainly at the cervical spine, with a higher incidence in men belonging to an age group between 30 and 60 years.

Astrocytoma is a generally benign neoplasm that affects the cervical and cervico-thoracic regions. Its incidence is higher in children and young adults.

Extramedullary tumours

Extramedullary tumours develop outside the spinal cord parenchyma. They are divided into intradural extramedullary tumours and extradural extramedullary tumours.

Intradural extramedullary tumours are neoplasms located within the dura mater that compress the spinal cord and its roots, with a tendency to invade the area of the parenchyma. They are benign tumours for the most part, and the most common tumours in this group are meningiomas or neurofibromas.

Extradural extramedullary tumours are neoplasms that develop outside the dura mater and also compress the spinal cord and its roots, and tend to invade the parenchyma. In most cases they are metastatic and arise from carcinomas (lungs, prostate, breast, kidneys, thyroid), lymphomas, lymphosarcomas or sarcomas.

Causes of spinal cord tumours

Although the causes of spinal tumours are still unknown, in most cases they are neoplasms of metastatic origin.

Symptoms of spinal cord tumours

The symptoms of spinal cord tumours may vary depending on the location and size of the tumour but the following symptoms can be found:

• Back pain not related to exertion, more severe pain when laying down
• Lumbago
• Spastic paresis
• Paresthesia
• Incontinence
• Motor loss
• Weakness
• Partial paralysis
• Erectile dysfunction

Diagnosis of spinal cord tumours

In case of suspected spinal cord tumour, first of all a neurological examination aimed at evaluating the general medical condition of the patient and his/her symptoms is required in order to define a full medical history.

Afterwards, the diagnosis is confirmed by means of magnetic resonance imaging (MRI) of the affected area and, if needed, by acomputed tomography (CT) scan. Depending on the location of the tumour, the specialist may also consider that a biopsy is required.

A rapid diagnosis is necessary to prevent that the deficits caused by the tumour mass become irreversible.

Treatment of spinal cord tumours

The treatment of spinal tumours varies according to the type, nature, location, and size of the tumour and the patient’s general medical condition.

If neurological deficits caused by spinal cord compression have been found, corticosteroids are needed to reduce medullary oedema.

Spinal cord neoplasms can be removed surgically only if their location permit surgery; otherwise, radiation therapy is required.