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Spinal Tumors

Tumori Spinali

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Definition and Etiology

Extradural tumors or tumors of the spine

Metastasis

75% of all patients with malignant tumors are affected by vertebral metastases. The most commonly reported neoplasms that cause vertebral metastases are: lung, breast, prostate, kidney, thyroid, and colon. The vertebral body is usually the starting point for metastasis growth. 95% of all spinal metastases are extradural.

 

Distribution

Lumbar: 22%

Thoracic: 70%

Cervical: 8%

 

The average age is 56 years.

 

Osteogenic tumors

  • Benign: osteoma, osteoid osteoma, osteoblastoma, giant cell tumors

  • Malignant: osteosarcoma, Ewing's sarcoma, myeloma

 

Cartilage tumors

  • Benign: chondroma, osteochondroma, chondroblastoma

  • Malignant: condrosarcoma

 

Vascular Tumors

  • Benign: hemangioma, lymphangioma, angioreticuloma

  • Malignant: Angiosarcoma, Hemangiopericytoma

 

Connective Tissue Tumors

  • Benign: fibroma, lipoma

  • Malignant: fibrosarcoma, liposarcoma

 

Intradural Extramedullary Tumors  

  • Benign: meningiomas, neuromas, dermoids, epidermoids, lipomas

  • Malignant: metastases

 

These tumors are "attached" to the nerve roots (neuromas) or to the dura mater (meningioma). The most common kind is the neuroma or schwannoma (30%). Meningiomas are the second most common (25%) tumor. Other tumors are more rare. About 40% of all neuromas and 80% of all meningiomas affect the thoracic segment. Neuromas affect any age group without gender prevalence, and they are seldom malignant. Meningiomas are more frequent in women (3:1 over males) between fifty and seventy years of age.

 

Intradural Intramedullary Tumors

  • Benign: ependymomas, juvenile astrocytomas, angioreticulomas, dermoids, epidermoids, cholesteatoma, lipomas

  • Malignant: anaplastic astrocytomas, glioblastomas, metastases

 

They are very rare and are prevalent in adults. The most common are ependymomas (45%) and astrocytomas (35%). Ependymomas affect slightly more males than females between 30-60 years of age and they are mainly found at a cervical level.

Astrocytomas are predominant in children and young adults, where they are located on a cervical and cervical-thoracic level. They are mostly benign.

Hemangioblastoma and lipoma represent respectively 2-3% of intramedullary neoplasms. Cavernous angiomas, dermoid and epidermal tumors, teratomas, metastases, are much more rare.

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