SPINAL TUMORS - Watsons Health
Spinal Tumor - WatsonsHealth

SPINAL TUMORS

Spinal tumors are not common and are malignant or benign.  Certain tumors spread directly or via veins, arteries and the lymphatic system. Malignant tumors occur in prostate, breast, lung and kidney are known to spread into the spinal cord. Spinal tumors can lead to spinal canal compression and result in neurologic dysfunction like paralysis, hence they are dangerous.

Types

Benign, Noncancerous Spinal Tumors

  • Osteochondroma is a slow growing tumor of the cartilage normally seen in adolescents. It is rare and is commonly seen in the rear spine.
  • Osteoid Osteoma is a small bone tumor usually less than 2 cm. It normally affects adolescents resulting in night pain and may lead to spinal deformity.
  • Osteoblastoma found in children and adolescents. These types of tumors can be aggressive, large and painful even result in paralysis and spinal deformity.
  • Aneurysmal Bone Cysts (ABCs) normally cause pain and swelling commonly affecting children and adolescents. These tumors can be quite vascular and large.
  • Giant Cell Tumor usually affects children, adolescents and young adults. These kinds of tumors can be seen at the thoracic, cervical, or lumbar segments of the spine, but are commonly found in the sacrum.
  • Hemangioma is seen most often in the thoracic spine. These tumors are known to affect adults and are progressive vascular masses that can result in vertebral collapse and slight paralysis.
  • Eosinophilic Granuloma is commonly seen in the children and adolescents. When this tumor is systemic it is termed Histiocytosis X. Rarely do these tumors lead to vertebral collapse and paraparesis. On occasion, they may heal naturally.

Malignant, Cancerous Spinal Tumors

  • Plasmacytoma found in middle aged and older adults. These tumors are seen in the pedicle and vertebral body and may lead to paraparesis.
  • Ewing or Ewing’s Sarcoma is an aggressive tumor found in adolescents and young adults. Sometimes, it may metastasize.
  • Lymphoma may be seen in one or more vertebral bodies in middle aged or older adults. In some cases the lymphatic system is involved.
  • Chondrosarcoma is a tumor which affects spinal cartilage in middle-aged adults. Though it grows slowly but can be dangerous. Normally aggressive medical intervention is needed.
  • Osteosarcoma is bone cancer present in adolescents and middle-aged adults. These tumors may metastasize needing aggressive medical therapy.
  • Chordoma is usually seen in adults and half of them involving the sacrum, although it can affect other parts of the spine. These tumors often need aggressive medical therapy.
  • Spine pain does not always denote the presence of tumor. But, early medical intervention is always recommended if spine pain does not resolve or if neurologic deficit is experienced.

 

Symptoms

The most common sign of spinal cancer is pain. Pain can arise from the tumor’s presence in the spinal column, causing spinal instability or pushing on sensitive nerve endings.

Some common signs of spinal tumors may include the following:

  • Pain in the back and/or neck pain, arm and/or leg
  • Weakness in muscle or numbness in the legs or arms
  • Difficulty to walk
  • General sensation loss
  • Difficulty with urination (incontinence)
  • Change in bowel movements (retention)
  • Paralysis to varying degrees
  • Spinal deformities
  • Pain or difficulty with standing

DIAGNOSIS

A variety of tests are available to diagnose metastatic spinal tumors, such as a physical exam, blood tests and imaging. A physical examination will involve a thorough patient history and a review of patient physical and neurological symptoms. Usually, a biopsy is needed to perform a final diagnosis.

Metastatic Spine Tumor Imaging. Various imaging modalities are used to evaluate patients with spinal tumors. Images are used to find tumor locations and size.

X-Ray. When a spinal fracture is suspected, X-ray will be used to identify and evaluate it. But, X-rays can only image bones and not soft tissues including a new tumor growth, further imaging using computed tomography (CT) or magnetic resonance imaging (MRI) is also part of the process.

Computed Tomography (CT scan). CT is frequently replacing X-ray for first-line imaging, as it clearly distinguishes bone from soft tissue (such as a tumor). A CT scan makes use of special X-ray equipment and computer software to improve images.

Magnetic Resonance Imaging (MRI scan). MRI is the most effective imaging method for visualizing spine tumors. It offers accurate information regarding the soft tissues and bony structures of the spine using magnetic field and pulses of radio wave energy to create images. Due to the magnetic energy, if patients have some types of metal implants or other devices (like a pacemaker), they cannot have a CT scan or an MRI instead.

 

TREATMENT

One or more of the below mentioned therapies may be used to treat the tumor or help relieve symptoms.

Corticosteroids: These drugs (like dexamethasone) may be prescribed to reduce swelling if a spinal tumor is pressing against the spinal cord. These tumors are treated immediately with surgery.

Surgery: Surgery can be used to remove some spinal tumors. Radiation therapy will be used to relieve pressure on the spinal cord.

Radiation therapy: Radiation therapy may be used alone or after a surgery to relieve pressure on the spinal cord. Stereotactic radiosurgery is an advanced type of treatment that involves radiation exactly on the spinal tumor, causing minimal impact to healthy tissue.

Chemotherapy: Drugs may be taken orally or by injection. They may be given alone or with other treatments.

Targeted therapies: These therapies are involved in fighting some kinds of spinal tumors. They attack cancer cells with the help of small molecules to block pathways that cells use to live and replicate.

Proton therapy: Proton therapy allows the delivery of high radiation doses directly to the tumor site, with no damage to adjacent healthy tissue. For certain patients, this therapy offers better cancer control with less effect on the body.

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