Intramedullary Spinal Cord Tumors

Excerpt

Spinal tumors comprise about 15% of all tumors in the central nervous system. These tumors are typically benign and cause symptoms primarily by compressing the spinal cord and nerves. Spinal tumors can be classified into 3 groups based on their locations—extradural, intradural-extramedullary, and intramedullary.

Extradural tumors are the most common type, occupying the vertebral body or structures outside the dura. This type of tumor is the most commonly associated with metastasis. Intradural extramedullary tumors, the second most common type, originate from the leptomeninges or nerve roots. These tumors are located inside the dura but external to the spinal cord, such as meningiomas or neurofibromas. The least common spinal cord tumors are intramedullary spinal cord tumors, comprising 20 to 30% of all intradural primary tumors and only 2 to 5% of all spinal cord tumors. Intramedullary spinal cord tumors arise from the spinal cord parenchyma, most commonly from glial tissue, and lead to invasion and destruction of adjacent gray and white matter. Ependymomas and astrocytomas are the most commonly encountered intramedullary spinal cord tumors, followed by hemangioblastomas. Other entities include lipomas, germ cell tumors, gangliogliomas, germinomas, lymphomas, and metastases.