Spinal cord tumor

Definition

Disease forming a mass in spinal cord

Spinal cord tumors arise in spinal cords and are classified into extradural tumor and intradural tumors. It is prevalent from young adults to those who are middle-aged. Most of them are benign and resectable, and curable especially when it is treated early. If untreated until growing larger, it can compress the spinal cord and adjacent blood vessels, resulting in pain, sensory abnormality, and muscle weakness.

Spinal cord tumors are tumors that arise in the spinal cord, a part of the central nervous system. They also include tumors arising in spinal nerves, cauda equina (nerve bundle at the end of the spinal cord), or adjacent tissue which compresses or invades the nerves.

They can be divided into extradural(out of dura), Intradural-extramedullary(in the dura and out of cord), and intramedullary (in the cord), depending on the arising location. The incidence is high in the order of intradural-extramedullary, extradural, and intramedullary.

Extradural tumors

  • The most common forms of extradural tumors are metastatic and compress the outer part of the dura. The metastasis are rare to the spinal cord itself or tissues except for the dura. Primary sites can include the lungs, breasts, prostate, bone tumors of the spinal column, lymphoma, and myeloma. In some cases, however, the primary site cannot be confirmed even after.
  • Intradural-extramedullary tumors

  • Most arise from the spinal nerve, meninges or cauda equina. Schwannoma and meningioma account for 70% of cases. Occasionally, a tumor arises through the inside and outside of dura. Other unusual tumors are hemangioma, lipoma, and teratoma.
  • Intramedullary tumors

  • Ependymoma, astrocytoma, and hemangioblastoma are included in this category. Unlike brain tumors, ependymoma is relatively more prevalent than astrocytoma.
  • Symptoms

    • 1.Spinal nerve stage
      : The first stage of spinal compression is generally the abnormality of movement. Pain and muscle weakness become evident. Slow-growing tumors, such as schwannoma or neurilemmoma, often cause tonic paralysis
    • 2.Brown-Séquard stage
      : If a right or left half is involved, the proprioception and vibration of the involved side disappears as well as the pain and temperature of the opposite side.
    • 3.Transection stage
      : In case of rapid progress asa metastatic tumor, transection symptoms, such as flaccid paralysis or loss of deep tendon reflex, loss of anal sphincter tone, loss of movement and sensory acuity, become apparent.

    Cause

  • It's not clear why most spinal tumors develop. Experts suspect that defective genes play a role. But it's usually not known whether such genetic defects are inherited, occur spontaneously or are caused by something in the environment, such as exposure to certain chemicals. In some cases, however, spinal cord tumors are linked to known inherited syndromes, such as neurofibromatosis 2 and von Hippel-Lindau disease.
  • Treatment

    Diagnosis : X-ray, MRI, myelogram, CT, angiogram

    • For primary spinal cords, surgical removal is the treatment of choice. Especially for benign tumors, complete excision should be performed, which would improve the possibility of neurological recovery and prevent relapse.