Spinal tumor
Tumor - spinal cordA spinal tumor is a growth of cells (mass) in or around the spinal cord.
Causes
Any type of tumor may occur in the spine, including primary and secondary tumors.
Primary tumors: most of these tumors are benign and slow growing.
- Astrocytoma: a tumor of the supporting cells inside the spinal cord
- Meningioma: tumor of the tissue that covers the spinal cord
- Schwannoma: a tumor of the cells surrounding the nerve fibers
- Ependymoma: a tumor of the cells that line the cavities of the brain
- Lipoma: a tumor of the fat cells
Secondary tumors or metastasis: these tumors are cancer cells coming from other areas of the body.
- Prostate, lung, and breast cancers
Prostate
Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-shaped structure that makes up part of a man's reproduc...
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Lung cancer is cancer that starts in the lungs. The lungs are located in the chest. When you breathe, air goes through your nose, down your windpipe...
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Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer:Ductal carcinoma starts in the tubes (du...
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Leukemia
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Lymphoma
Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.
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Myeloma
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The cause of primary spinal tumors is unknown. Some primary spinal tumors occur with certain inherited gene mutations.
Spinal tumors can be located:
- Inside the spinal cord (intramedullary)
- In the membranes (meninges) covering the spinal cord (extramedullary - intradural)
- Between the meninges and bones of the spine (extradural)
- In the spine bones (vertebrae)
As it grows, the tumor can affect the:
- Blood vessels
- Bones of the spine
- Meninges
- Nerve roots
- Spinal cord cells
The tumor may press on the spinal cord or nerve roots, causing damage. With time, the damage may become permanent.
Symptoms
The symptoms depend on the location, type of tumor, and your general health. Secondary tumors that have spread to the spine from another site (metastatic tumors) often progress quickly. Primary tumors often progress slowly over weeks to years.
Symptoms may include:
- Abnormal sensations or loss of sensation, especially in the legs
Abnormal sensations
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
Read Article Now Book Mark Article - Back pain that gets worse over time, is often in the middle or lower back, is usually severe and not relieved by pain medicine, gets worse when lying down or straining (such as during a cough or sneeze), and may extend to the hips or legs
- Loss of bowel control, bladder leakage
Loss of bowel control
Bowel incontinence is the loss of bowel control, causing you to unexpectedly pass stool. This can range from sometimes leaking a small amount of sto...
Read Article Now Book Mark ArticleBladder leakage
Urinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries ...
Read Article Now Book Mark Article - Muscle contractions, twitches, or spasms (fasciculations)
Muscle contractions,
Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of on...
Read Article Now Book Mark Article - Muscle weakness (decreased muscle strength) in the legs that causes falls, makes walking difficult, and may get worse (progressive) and lead to paralysis
Muscle weakness
Weakness is reduced strength in one or more muscles.
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Exams and Tests
A nervous system (neurological) examination may help pinpoint the location of the tumor. The health care provider may also find the following during an exam:
- Abnormal reflexes
- Increased muscle tone
- Loss of pain and temperature sensation
- Muscle weakness
- Tenderness in the spine
These tests may confirm spinal tumor:
- Spinal CT
Spinal CT
A lumbosacral spine CT is a computed tomography scan of the lower spine and surrounding tissues.
Read Article Now Book Mark Article - Spine MRI
- Spine x-ray
Spine x-ray
A thoracic spine x-ray is an x-ray of the 12 chest (thoracic) bones (vertebrae) of the spine. The vertebrae are separated by flat pads of cartilage ...
Read Article Now Book Mark Article - Cerebrospinal fluid (CSF) examination
Cerebrospinal fluid (CSF) examination
A CSF cell count is a test to measure the number of red and white blood cells that are in cerebrospinal fluid (CSF). CSF is a clear fluid that is in...
Read Article Now Book Mark Article - Myelogram (x-ray of the spinal canal that contains the spinal cord)
Myelogram
A lumbosacral spine x-ray is a picture of the small bones (vertebrae) in the lower part of the spine. This area includes the lumbar region and the s...
Read Article Now Book Mark Article - PET scan
Treatment
The goal of treatment is to reduce or prevent nerve damage caused by pressure on (compression of) the spinal cord and ensure that you can walk.
Treatment should be given quickly. The more quickly symptoms develop, the sooner treatment is needed to prevent permanent injury. Any new or unexplained back pain in a patient with cancer should be thoroughly investigated.
Treatments include:
- Corticosteroids (dexamethasone) may be given to reduce inflammation and swelling around the spinal cord.
- Emergency surgery may be needed to relieve compression on the spinal cord. Some tumors can be completely removed. In other cases, part of the tumor may be removed to relieve pressure on the spinal cord.
- Radiation therapy may be used with, or instead of, surgery.
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark Article - Chemotherapy has not been proven effective against most primary spinal tumors, but it may be recommended in some cases, depending on the type of tumor.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Read Article Now Book Mark Article - Physical therapy may be needed to improve muscle strength and the ability to function independently.
Outlook (Prognosis)
The outcome varies depending on the tumor. Early diagnosis and treatment usually leads to a better outcome.
Nerve damage often continues, even after surgery. Although some amount of permanent disability is likely, early treatment may delay major disability and death.
When to Contact a Medical Professional
Contact your provider if you have a history of cancer and develop severe back pain that is sudden or gets worse.
Go to the emergency room or call 911 or the local emergency number if you develop new symptoms, or your symptoms get worse during the treatment of a spinal tumor.
References
DeAngelis LM. Tumors of the central nervous system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 180.
Jakubovic R, Ruschin M, Tseng CL, Pejovic-Milic A, Sahgal A, Yang VXD. Surgical resection with radiation treatment planning of spinal tumors. Neurosurgery. 2019;84(6):1242-1250. PMID: 29796646 pubmed.ncbi.nlm.nih.gov/29796646/.
Moron FE, Delumpa A, Szklaruk J. Spinal tumors. In: Haaga JR, Boll DT, eds. CT and MRI of the Whole Body. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 30.
Niglas M, Tseng C-L, Dea N, Chang E, Lo S, Sahgal A. Spinal cord compression. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 54.
Soliman H, Fridely J, Oyelese A, Gokaslan ZL. Management of spinal metastatic tumors. In: Ellenbogen RG, Sekhar LN, Kitchen ND, da Silva Hb, eds. Principles of Neurological Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 32.
Vertebrae - illustration
The vertebral column is made up of 26 bones that provide axial support to the trunk. The vertebral column provides protection to the spinal cord, which runs through its central cavity. Between each vertebra is an intervertebral disk, which acts as a shock absorber.
Vertebrae
illustration
Spinal tumor - illustration
This photograph shows the presence of tumor within the vertebrae. The tumor is dense white against the red interior of the bone.
Spinal tumor
illustration
Vertebrae - illustration
The vertebral column is made up of 26 bones that provide axial support to the trunk. The vertebral column provides protection to the spinal cord, which runs through its central cavity. Between each vertebra is an intervertebral disk, which acts as a shock absorber.
Vertebrae
illustration
Spinal tumor - illustration
This photograph shows the presence of tumor within the vertebrae. The tumor is dense white against the red interior of the bone.
Spinal tumor
illustration
Review Date: 8/15/2022
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.