Spinal Tumor

General Information


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Description:

  • Metastatic spinal tumor
  • Spinal metastases
  • Vertebral metastases
  • Benign spinal tumor


Who is most affected:

  • Benign < 30, malignant > 40


Incidence/Prevalence:

  • 1%-2% patients with spinal pain (LBP)


Causes and Risk Factors

Causes:

  • Metastatic tumors common – lung, breast, prostatic, renal cell, colon, thyroid, lymphoma (retroperitoneal)
  • Intradural extramedullary spinal metastases (drop metastases) reported in about 1% patients with glioblastoma multiforme (CMAJ 2006 Aug 29;175(5):475)
  • Primary malignant neoplasms uncommon – vertebral bodies
    • Number 1 multiple myeloma, plasmacytoma, osteoblastoma
    • Number 2 chordoma (mid-vertebral body, destructive, rare)
  • Benign neoplasms rare – posterior vertebra – number 1 osteoid osteoma (pedicles, 15-45), eosinophilic granuloma, aneurysmal bone cyst, giant cell tumor, ependymoma (T12-L1, from arachnoid granulations, surgery curative), neurofibroma, lipoma, meningioma


Pathogenesis:

  • metastasis via venous plexus (low pressure, low velocity)


Complications and Associated Conditions

Complications:

  • Most osteolytic especially colon, thyroid and renal cancers
  • Breast, lung and prostate cancer metastases can be osteoblastic