“A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and/or spinal column. These cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Primary tumors originate in the spine or spinal cord, and metastatic or secondary tumors result from cancer spreading from another site to the spine.
Spinal tumors may be referred to by the region of the spine in which they occur. These basic areas are cervical, thoracic, lumbar and sacrum. Additionally, they also are classified by their location in the spine into three major groups: intradural-extramedullary, intramedullary and extradural.
The most common of these types of tumors develop in the spinal cord’s arachnoid membrane(meningiomas), in the nerve roots that extend out from the spinal cord (schwannomas and neurofibromas) or at the spinal cord base (filum terminale ependymomas). Although meningiomas are often benign, they can be difficult to remove and may recur. Nerve root tumors are also generally benign, although neurofibromas may become malignant over time. Ependymomas at the end of the spinal cord can be large, and the delicate nature of fine neural structures in that area may complicate treatment.
Intramedullary: These tumors grow inside the spinal cord, most frequently occurring in the cervical (neck) region. They typically derive from glial or ependymal cells that are found throughout the interstitium of the spinal cord. Astrocytomas and ependymomas are the two most common types. They are often benign, but can be difficult to remove. Intramedullary lipomas are rare congenital tumors most commonly located in the thoracic spinal cord.
Extradural: These lesions are typically attributed to metastatic cancer or schwannomas derived from the cells covering the nerve roots. Occasionally, an extradural tumor extends through the intervertebral foramina, lying partially within and partially outside of the spinal canal.
Metastatic spinal tumors
The spinal column is the most common site for bone metastasis. Estimates indicate that at least 30 percent and as high as 70 percent of patients with cancer will experience spread of cancer to their spine.
Common primary cancers that spread to the spine are lung, breast and prostate. Lung cancer is the most common cancer to metastasize to the bone in men, and breast cancer is the most common in women. Other cancers that spread to the spine include multiple myeloma, lymphoma, melanoma and sarcoma, as well as cancers of the gastrointestinal tract, kidney and thyroid. Prompt diagnosis and identification of the primary malignancy is crucial to overall treatment. Numerous factors can affect outcome, including the nature of the primary cancer, the number of lesions, the presence of distant non-skeletal metastases and the presence and/or severity of spinal-cord compression.
Pediatric spinal tumors
Primary spinal tumors are rare in children and are challenging to treat. Incidence and outcome vary by subtype, a listing of which can be quite broad but include the following:
aneurysmal bone cyst
giant-cell tumor of bone
Unlike adults, children have not achieved complete skeletal growth, which doctors must take into account when considering treatment. Other factors to consider are spinal stability, surgical versus nonsurgical interventions and preservation of neurological function.”