Spinal cord tumors
- William C Welch, MD, FACS, FICS
William C Welch, MD, FACS, FICS
- Professor of Neurosurgery
- University of Pennsylvania School of Medicine
- Chief of Neurological Surgery
- The Pennsylvania Hospital
- David Schiff, MD
David Schiff, MD
- Professor of Neurology, Neurological Surgery, and Medicine
- University of Virginia School of Medicine
- Peter C Gerszten, MD, MPH, FACS
Peter C Gerszten, MD, MPH, FACS
- Professor of Neurosurgery and Radiation Oncology
- University of Pittsburgh Medical Center
- Section Editors
- Jay S Loeffler, MD
Jay S Loeffler, MD
- Section Editor — Neurooncology
- Professor of Radiation Oncology
- Harvard Medical School
- Patrick Y Wen, MD
Patrick Y Wen, MD
- Section Editor — Neurooncology
- Professor of Neurology
- Harvard Medical School
Spinal cord tumors can occur within or adjacent to the spinal cord. They are considered to be intraaxial in location and can be either primary or metastatic. Primary spinal cord tumors account for 2 to 4 percent of all primary central nervous system (CNS) tumors, one-third of which are located in the intramedullary compartment.
Spinal cord tumors can be classified according to their anatomic location (figure 1):
●Intramedullary – Intramedullary tumors arise within the spinal cord itself. Most primary intramedullary tumors are either ependymomas or astrocytomas. Metastases are being recognized with increasing frequency, primarily because of improvements in imaging modalities.
●Intradural-extramedullary – Tumors arising within the dura but outside the actual spinal cord are termed intradural-extramedullary. The most common tumors in this group are meningiomas and nerve sheath tumors. (See "Epidemiology, pathology, clinical features, and diagnosis of meningioma" and "Intradural nerve sheath tumors".)
●Extradural – Extradural tumors are usually metastatic and most often arise in the vertebral bodies. Metastatic lesions can cause spinal cord compression either by epidural growth that results in extrinsic spinal cord or cauda equina compression or less frequently by intradural invasion. (See "Clinical features and diagnosis of neoplastic epidural spinal cord compression, including cauda equina syndrome".)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Physical examination
- INTRAMEDULLARY TUMORS
- - Ependymoma
- - Myxopapillary ependymoma
- - Anaplastic ependymoma
- INTRADURAL EXTRAMEDULLARY TUMORS
- Nerve sheath tumors
- EXTRADURAL PRIMARY TUMORS
- - Surgery and RT
- - Systemic therapy
- Plasmacytomas and multiple myeloma
- Langerhans cell histiocytosis (eosinophilic granuloma)
- Benign lesions
- SUMMARY AND RECOMMENDATIONS
- Primary intramedullary tumors
- Intradural extramedullary lesions
- Extradural tumors