Definition
Spinal cord tumors can develop inside or outside the medullary parenchyma, following the transformation in the neoplastic sense of the various nerve elements or of the membranes that cover them.
Furthermore, the spinal cord may be affected by compression by bone neoplasms that originate from the vertebrae or from the infiltration / diffusion of tumor metastases from other organs and tissues.
Intramedullary tumors
Intramedullary tumors cause direct damage to the spinal tissue, as they infiltrate and destroy the parenchyma; in addition, they can spread over several segments of the marrow or induce syringomyelia.
The most common forms are ependymomas and astrocytomas. The prevailing localization is thoracic and cervico-thoracic.
Extramedullary tumors
Extramedullary tumors can be intradural (outside the parenchyma, but inside the meninges) or extradural (inside the vertebral canal, but outside the dural lining); these neoplastic masses cause neurological damage due to spinal cord compression or nerve roots.
The most common intradural tumor is neurinoma (or schwannoma), followed by meningioma; other forms are more rare.
Most extradural tumors, on the other hand, are secondary to neoplastic metastases originating from lymphomas or carcinomas of the lung, breast, prostate, kidney and thyroid.
Most common symptoms and signs *
- Asthenia
- Muscular atrophy and paralysis
- Muscular atrophy
- Bladder dysfunction
- Neck pain
- Hand and wrist pain
- Arm pain
- Sore legs
- Legs tired, heavy legs
- Fecal incontinence
- Intracranial hypertension
- Hypertonia
- Hypoaesthesia
- weakness
- Orthostatic hypotension
- Muscular hypotrophy
- Backache
- Paraplegia
- Paresthesia
- Loss of coordination of movements
- Bedsores
- Spinal stenosis
- Spastic tetraparesis
Further indications
Signs and symptoms depend on the type, location and rate of tumor growth. However, there is frequently a worsening neck and back pain, unrelated to strain, worsened by lodging and, sometimes, radiated along the course of the nerves whose roots are compressed. Follow neurological problems related to the suffering of spinal cord and nerve roots, such as sensory and / or motor deficits of one or more limbs (eg weakness or numbness in the arms or legs) and alteration of normal bowel habits or bladders (eg disorders of sphincter control). These disorders are usually bilateral.
Compression symptoms of nerve roots are frequent. They include: back pain and paresthesia, hyposthenia (reduction in muscle strength) and atrophy with radicular distribution. Compression and / or infiltration of the marrow may also cause dysfunction of some or all types of sensitivities at the level of a particular segment of the spinal cord and below it.
The diagnosis of a spinal cord tumor is obtained with the magnetic resonance of the affected area. CT is an alternative, but is less accurate.
Treatment may include the use of corticosteroids (to reduce bone marrow edema and preserve function) and surgical removal of well-localized primitive medullary tumors. If the tumor masses cannot be excised, radiotherapy or chemotherapy is used, with or without surgical decompression.
