Primary spinal cord tumors are divided into three categories based upon anatomic location. They are unique amongst all spinal column masses in that they require inci sion of the spinal cord for surgical access. Spinal tumors are neoplasms located in either the vertebral column or the spinal cord. Part iepidemiology, pathophysiology, and diagnosis. Intramedullary spinal cord tumors are uncommon in children, and delayed diagnosis is common.
Jan 30, 2020 intramedullary spinal cord tumors imscts, like the one depicted in the image below, refer to a subgroup of intradural spinal tumors that arise from cells within the spinal cord, as opposed to adjacent structures such as the nerve roots or meninges. A long duration of symptoms prior to diagnosis is typical. Pain is typically local at tumor level, but may radiate. Intradural spinal cord tumours are an uncommon but important consideration in the differential diagnosis of patients with back pain, radicular pain, sensorimotor deficits, or sphincter dysfunction. Tumors can grow along the spinal cord, just as they can in other parts of your body, such as the lungs or liver. Intramedullary spinal cord tumors pdf free download ebook description abundantly illustrated with more than 1,850 figures, this comprehensive monograph describes the experience gained through the treatment of patients with spinal tumors over a 25year period. Pdf intramedullary spinal cord tumors researchgate.
In contrast, the benign encapsulated tumors such as meningiomas and neurofibromas constitute between 55 and 65% of all primary spinal tumors. Intramedullary intramedullary tumors arise within the spinal cord itself. Sep 05, 2017 intramedullary spinal cord tumors pdf here is the first book in 30 years to cover all diagnostic and therapeutic aspects of intramedullary spinal cord tumors imts, a relatively rare but often misdiagnosed type of tumor. Intradural spinal tumours can be divided into intramedullary and extramedullary spinal cord tumours on the basis of their anatomical relation to the spinal parenchyma. Unlike the situation in adults, lowgrade astrocytomas predominate followed by ependymomas and other. Primary spinal cord tumors society for neurooncology. Department of orthopaedic surgery, keio university. Despite their rarity, these lesions are important to the radiologist because magnetic resonance mr imaging is the preoperative study of choice to narrow the differential diagnosis and guide surgical resection. The diagnosis and management of intramedullary spinal cord tumors have been significantly influenced by new diagnostic and surgical tools such as mri, ultrasonic aspiration, intraoperative ultrasound, and. Intramedullary tumors are rare, accounting for only 5 to 10% of all spinal tumors. Objectives intramedullary spinal cord tumors imsct are rare neoplasms that can potentially lead to severe. The diagnosis and management of intramedullary spinal cord tumors have been significantly influenced by new diagnostic and surgical tools such as mri, ultrasonic aspiration, intraoperative ultrasound, and evoked potential monitoring. In contrast, the benign encapsulated tumors such as meningiomas and neurofibromas constitute.
Primary spinal cord tumors account for 2 to 4 percent of all primary central nervous system cns tumors, onethird of which are located in the intramedullary compartment. Outcome after operative treatment of intramedullary spinal cord tumors in adults. In a large postmortem study, intramedullary spinal cord metastases were found in only 2% of 627 patients with systemic cancer. In spite of advancements in neuroimaging and microsurgical techniques, surgery for intramedullary spinal cord tumors isct remains a challenging task. The surgical treatment of intramedullary spinal cord tumors. Because of slowgrowth, symptoms precede tumor discovery an average of 2 years. With the advancement of surgical technique and equipment, more aggressive surgery is possible. From january 1962 to may 1979, 23 patients with biopsyproved intramedullary spinal cord tumors were treated initially with total resection, subtotal resection, irradiation, or subtotal resection a. Intramedullary spinal cord tumors imscts, like the one depicted in the image below, refer to a subgroup of intradural spinal tumors that arise from cells within the spinal cord, as opposed to adjacent structures such as the nerve roots or meninges. Intramedullary spinal cord tumors in children springerlink. Nonenhancing intramedullary astrocytomas and other mr imaging. Pain often is the earliest symptom, characteristically occurring at night when the patient is supine.
Intramedullary astrocytomas are glial tumors responsible for approximately 60% of all spinal cord tumors in children and adolescents, despite affecting patients of all ages. Intramedullary spinal cord tumors iscts are rare neoplasms, accounting for only 24% of central nervous system tumors. Intramedullary spinal cord tumors imscts are relatively rare tumors that account for 410% of central nervous system tumors but account for approximately 35% of pediatric intraspinal tumors 1. The surgical removal of isct is still believed to carry a significant risk for surgical damage and, therefore, neurologic dysfunction. Intramedullary spinal cord tumors and pseudotumors. Intramedullary spinal cord tumors ependymomas ependymomas are rare, unencapsulated glial tumors of the brain, but they represent the most common form of imsct in adults and account for. Intramedullary spinal cord tumors imsct account for only 410% of all primary central nervous system cns neoplastic lesions and 20% of all spinal cord tumors in adults. Management of intramedullary spinal cord tumors sciencedirect. The surgical removal of isct is still believed to carry a. Although astrocytomas represent approximately 30% of spinal cord tumors, intramedullary astrocytomas are rare because spinal cord tumor accounts for 4%10% of central nervous system tumors. Intramedullary spinal cord tumors ependymomas ependymomas are rare, unencapsulated glial tumors of the brain, but they represent the most common form of imsct in adults and account for approximately 50% 60% of all intramedullary tumors. They are the most common childhood intramedullary neoplasms of the spinal cord and are second only to ependymomas. Compared to their intracranial counterparts, spinal cord tumors are quite rare, accounting for less than 10% of all central nervous system cns lesions. They account for 20% of all intraspinal tumors in adults and 35% of all intraspinal tumors in children 8.
Pdf surgery of intramedullary spinal cord tumors nezih. As a rule, intramedullary tumors are more common in children, and extramedullary tumors are more. Spinal cord involvement in nf is typically from extramedullary growth of spinal nerve root tumors. Although the intramedullary spinal cord sc tumors are relatively rare tumors, accounting for only 2% to 8. Intramedullary spinal tumors are rare, representing 410% of all cns tumors and less than 10% of all pediatric cns neoplasms 5. Arima h, hasegawa t, togawa d, yamato y, kobayashi s, et al. Nov 25, 2016 anesthesia for intramedullary spinal cord tumors figure. Raco a, esposito v, lenzi j, piccirilli m, delfini r, cantore g. They are much less common than brain tumors and are thought to account for 510% of all. Despite their rarity, these lesions are important to the radiologist because magnetic resonance.
The authors have treated 14 cases of intramedullary spinal cord tumors 5 astrocytomas, 2 ependymomas, 5 hemangioblastomas, 1 dermoid, and 1 lipoma during the past 12 years. Intramedullary spinal cord tumors in nf have been reported as scattered, single cases in the. Nakamura m, ishii k, watanabe k, tsuji t, takaishi h, matsumoto m. Symptoms not specific to spinal cord tumors and may be present in any myelopathic process. Malignant intramedullary spinal cord tumors springerlink. Intradural spinalcord tumours are an uncommon but important consideration in the differential diagnosis of patients with back pain, radicular pain, sensorimotor deficits, or sphincter dysfunction. Jan 25, 2019 compared to their intracranial counterparts, spinal cord tumors are quite rare, accounting for less than 10% of all central nervous system cns lesions. A tumor forms in the spinal cord when cells grow too quickly. Management and outcomes of intramedullary spinal cord tumors. Pediatric intramedullary spinal cord tumors are rare and make up only a small percentage of all central nervous system neoplasms. Jun 18, 2017 lee m, rezai ar, freed d, epstein fj 1996 intramedullary spinal cord tumors in neurofibromatosis. Department of orthopaedic surgery, keio university, japan. Optimum management of these patients remains ambiguous. Longterm followup of intramedullary spinal cord tumors.
Intramedullary spinal cord tumors astrocytoma, ependymoma are uncommon neoplasms and comprise about 4% of central nervous system tumors in children. These types of tumors can appear anywhere along the spinal cord but. Management and outcomes of intramedullary spinal cord. Of the true intramedullary spinal cord tumors, the vast majority are gliomas, with ependymomas occurring most frequently in the adult population and astrocytomas. Intramedullary spinal cord tumors pdf free download ebook description abundantly illustrated with more than 1,850 figures, this comprehensive monograph. Intramedullary spinal cord tumours imscts are rare neoplasms that can lead to severe neurological deterioration. Ependymomas, which are common in adults, are relatively uncommon in children. Surgical treatment of intramedullary spinal cord tumors. Hemangioblastoma and glial tumors represent more than 90% of intramedullary spinal cord tumors, with ependymomas. Intramedullary spinal tumors radiology reference article. However, some inflammatory lesions may mimic an intramedullary tumor.
Intramedullary tumors are masses of tissue that form as a result of abnormal cell growth within the spinal cord. Intramedullary spinal cord neoplasms are rare, accounting for about 4%10% of all central nervous system tumors. These neoplasms are predominantly benign histologically. These types of tumors can appear anywhere along the spinal cord but are most often found in the cervical area, where more neural tissue is present. Spinal cord tumors can be classified according to their anatomic location. Stafford, complete removal of a large intramedullary tumor ependymoma from the cervical portion of. There are three main types of spinal tumors classified based on their location. Astrocytomas account for approximately 30% of spinal cord tumors. Preoperative study left demonstrates a relatively wellcircumscribed enhancing intramedullary lesion associated with syrinx and spinal cord enlargement. Pre and postoperative t 1weighted images of a patient with cervicothoracic region ependymoma, after contrast injection. They are much less common than brain tumors and are thought to account for 510% of all intrinsic tumors of the central nervous system. Intramedullary spinal cord tumors imscts comprise 2030% of all spinal cord tumors in adults and 410% of all tumors of the spinal cord in children. Intramedullary spinal cord tumors imscts comprise about 20% of all intraspinal tumors ists, and the two most common imscts are ependymomas and astrocytomas.
A retrospective analysis of 76 patients intramedullary spinal cord tumors imscts comprise about 20% of all intraspinal tumors ists, and the two most common imscts are ependymomas and astrocytomas, respectively. These neoplasms are predominantly benign histologically, regardless of size, with a large percentage being astrocytomas or gangliogliomas. Intramedullary spinal cord tumours imscts are rare primary spine neoplasms of the central nervous system cns and remain a clinical challenge due to. The surgical treatment of intramedullary spinal cord. They are usually benign and may involve only a short segment of the spinal cord or almost its entire length holocord tumor. Intramedullary spinal cord tumors in nf have been reported as scattered, single cases in the literature.
Intramedullary spinal cord tumors in neurofibromatosis. Intramedullary spinal cord tumors imscts comprise about 20% of all intraspinal tumors ists, and the two most common imscts are ependymomas and astrocytomas, respectively. Stafford, complete removal of a large intramedullary tumor ependymoma from the cervical portion of the spinal cord. That is the reason why, one should pay attention to spinal cord morphology on mri to. However, this association has not been clearly defined as have other nervous system neoplasms that are typically linked with nf. Nonenhancing intramedullary astrocytomas and other mr. Intramedullary spinal cord tumors pdf here is the first book in 30 years to cover all diagnostic and therapeutic aspects of intramedullary spinal cord tumors. To evaluate our recent treatment strategy for intramedullary spinal cord tumors. Primary spine tumors are rare neoplasms that can lead to significant patient morbidity and mortality.
389 872 100 680 1367 1398 1554 1369 1407 123 1033 1676 1536 1032 297 564 1388 277 272 395 1223 392 103 955 481 1229 1409 84 1595 819 686 53 555 551 843 446 1434 674 1032 122 820 1478 205 1496 1179 1274 1270 1099 800 87