Spinal tumor

Spinal tumors are neoplasms located in the spinal cord. They are mostly metastases from primary cancers elsewhere (commonly breast, prostate and lung cancer). Primary tumors may be benign (e.g. hemangioma) or malignant in nature.

Depending on their location, the spinal cord tumors can be:

• Extradural - outside the dura mater lining
• Intradural - part of the dura
• Intramedullary - inside the spinal cord

The symptoms seen are due to spinal nerve compression and weakening of the vertebral structure. Incontinence and decreased sensitivity in the saddle area (buttocks) are generally considered warning signs of spinal cord compression by the tumor. Back pain in a patient with known malignancy may prompt a bone scan to confirm or exclude spinal metastasis.

Diagnosis

MRI and bone scanning are used for diagnostic purposes. This assesses not only the location of the tumor(s) but also their relationship with the spinal cord and the risk of cord compression.

Treatment

• Steroids may be administered if there is evidence of spinal cord compression. These do not affect the tumoral mass itself, but tend to reduce the inflammatory reaction around it, and thus decrease the overall volume of the mass impinging on the spinal cord.
• Radiotherapy
• Surgery is sometimes possible