Neurosurgery: Spinal Cord Tumor

Spinal Cord Tumor

Malignancy Risk

  • Most are Benign
  • By Site:
    • Intradural: Most Benign
    • Extradural: Most Malignant

Tumor Types

  • Intramedullary – Originate Within the Spinal Cord
    • Ependymoma
    • Astrocytoma
    • Metastases – Rare
  • Intradural Extramedullary – Originate Within the Dura but Outside the Spinal Cord
    • Meningioma
    • Nerve Sheath Tumor
  • Extradural – Originate Outside the Dura, Vertebral Body, etc.
    • Metastatic Lesions Most Common
    • Most Common Primary Sites: Prostate, Breast & Lung Cancers

Presentation

  • Pain
  • Weakness & Sensory Loss Distal to the Lesion
  • Sphincter Dysfunction

Diagnosis

  • Initial Imaging: MRI with Contrast Preferred
  • Primary Diagnosis: Pathology (Surgical or Stereotactic Biopsy)

Treatment

  • Definitive Management Depends on Pathology, Performance Status & Prognosis
  • Options:
    • Surgical Resection
    • Radiation Therapy (RT)
    • Chemotherapy
  • Corticosteroids Can Reduce Peritumoral Edema – Helps with Some Symptomatic Relief