Spinal Cord Tumor – Causes, Symptoms & Treatment
A spinal cord tumor is an abnormal growth in or around the spinal cord that can cause serious neurological symptoms. Early diagnosis and treatment are essential.
Things worth knowing about "Spinal cord tumor"
A spinal cord tumor is an abnormal growth in or around the spinal cord that can cause serious neurological symptoms. Early diagnosis and treatment are essential.
What is a Spinal Cord Tumor?
A spinal cord tumor is an abnormal mass of tissue that develops within the spinal cord itself, in the membranes (meninges) surrounding it, or in the adjacent vertebral structures. These tumors can be benign (non-cancerous) or malignant (cancerous) and may cause significant neurological damage by compressing nerve fibers. Although relatively rare, spinal cord tumors can occur at any age.
Types of Spinal Cord Tumors
Spinal cord tumors are classified according to their location within the spinal canal:
- Intramedullary tumors: These grow within the spinal cord tissue itself. Common types include ependymomas and astrocytomas.
- Intradural-extramedullary tumors: Located inside the dura mater (the outer membrane of the spinal cord) but outside the cord itself. Meningiomas and neurofibromas belong to this category.
- Extradural tumors: These are found outside the dura mater, often in the vertebral body or the epidural space. They are frequently caused by metastases from other cancers.
Causes and Risk Factors
The exact causes of primary spinal cord tumors are largely unknown. The following factors are associated with an increased risk:
- Genetic conditions: Neurofibromatosis type 1 and type 2, Von Hippel-Lindau syndrome
- Radiation exposure: Previous radiation therapy to the spinal region
- Secondary tumors (metastases): The most common cause of extradural tumors, originating from lung, breast, prostate, or kidney cancer
- Immune suppression: Increased risk of certain spinal lymphomas in individuals with HIV or following organ transplantation
Symptoms
Symptoms depend greatly on the size and location of the tumor. Common signs include:
- Back or neck pain that worsens at night or when lying down
- Muscle weakness or paralysis in the arms or legs
- Sensory disturbances such as numbness, tingling, or a burning sensation
- Gait problems and loss of coordination
- Bladder and bowel dysfunction (incontinence or urinary retention)
- Sexual dysfunction
Symptoms often develop gradually over weeks to months, but can also deteriorate suddenly.
Diagnosis
Diagnosing a spinal cord tumor involves several steps:
- Neurological examination: Assessment of reflexes, muscle strength, and sensation
- Magnetic Resonance Imaging (MRI): The preferred imaging method for visualizing the spinal cord and precisely locating the tumor, typically performed with contrast enhancement
- Computed Tomography (CT): Used as a complement to MRI, particularly to assess bony structures
- Biopsy: Tissue sampling for histological confirmation of the diagnosis
- Lumbar puncture (spinal tap): Analysis of cerebrospinal fluid for tumor cells
- Laboratory tests and staging investigations: Performed when metastatic disease is suspected
Treatment
Treatment depends on the type, location, and extent of the tumor, as well as the overall health of the patient:
Surgery
Neurosurgical removal of the tumor is often the first-line treatment. In cases of benign, well-defined tumors, complete removal may be possible. The goal is always maximal tumor resection while preserving neurological function.
Radiation Therapy
Radiation therapy is used when the tumor cannot be completely removed surgically, for malignant tumors, or in cases of recurrence. Stereotactic radiosurgery (e.g., Gamma Knife) allows highly precise radiation delivery while minimizing damage to surrounding healthy tissue.
Chemotherapy
Chemotherapy is indicated for certain malignant spinal tumors (e.g., spinal lymphomas, high-grade ependymomas) or for metastatic disease.
Corticosteroids
Corticosteroids such as dexamethasone may be administered acutely to reduce tumor-related swelling and relieve symptoms.
Rehabilitation
Following treatment, neurological rehabilitation is often necessary to restore lost functions as much as possible and to improve quality of life.
Prognosis
The prognosis depends primarily on the tumor type, the extent of neurological damage before treatment, and the feasibility of complete surgical removal. Benign tumors that can be fully resected often carry a favorable long-term prognosis. For malignant or metastatic tumors, outcomes vary considerably between individuals.
References
- Leitlinienprogramm Onkologie (German Cancer Society, AWMF): S2k Guideline on Intracranial Meningiomas and Spinal Tumors, 2022.
- Fehlings MG et al. - A clinical practice guideline for the management of patients with degenerative cervical myelopathy and spinal cord tumors. Spine, 2012.
- World Health Organization (WHO): Classification of Tumours of the Central Nervous System, 5th Edition, 2021.
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