SPINAL TUMOURS

Classification:

• Extra dural.• Intra dural extra medullary.• Intra dural intra medullary.

Extradural:1- Metastasis.

2- Bone tumours:

Benign: Osteoma

Malignant: Sarcoma

3- Cartilage: Chondroma, Chondrosarcoma

4- Blood tumours:

Myeloma, Lymphoma, Histocytosis.

5- Chordoma.

6- Vascular: Hemangioma, Hemangiolipoma.

Intradural extramedullary:1- Meningioma.

2- Schwanoma.

3- Peripheral nerve tumours.

4- Epidermoid and dermoid.

5- Lipoma.

6- Metastasis: C.S.F, Blood born

Intradural intramedullary:1- Astrocytoma.

2- Ependymoma.

3- Lipoma.

4- Dermoid, epidermoid.

5- Teratoma.

6- Metastasis.

7- Chloroma (leukemia).

8- Haemangioblastoma.

9- Haemangioma.

Clinical Presentation

A- Extradural lesions:

1- Pain: bone acke, root pain.

2- Motor weakness.

3- Sensory loss.

4- Sphineteric affection.

5- Deformity.

B- Intradural extramedullary:

1- Motor weakness.

2- Sensory loss.

3- Pain (root pain).

4- Sphinecteric affection.

Brown-squared syndrome.

5- Skin manifestations.

C- Intradural intramedullary:

1- Motor weakness.

2- Sensory loss.

3- Sphincteric affection.

4- Deformity.

Tumour of meninges:

• Tumours of meningeothelial cells:

1-meningioma(25-45%) -meningeothelial -transitional -fibrous -angiomatous -secretory -psammomatous -lymphoblastic -clear cell

• 2-Atypical meningioma

• 3-Anaplatic meningioma

• Mesenchymal, non meningothelial tumour:

*Benign: Lipoma….. *Malignat: Rhabdomyosarcoma

• Tumour of uncertain origin:

Capillary hemangioblastoma

Shwannoma

• 30% of spinal tumor• From sensory devision of spinal

nerve• At lumobsacral region• Associated with NF2

Neurofibroma

• Adult

• Two types: Intraneural, diffuse

• NF1

Malignant peripheral nerve sheath tumor(MPNST)

• Rare

• De novo or after neurofibroma

• Pathological picture

TUMOUR OF RELEATED STRUCTURE

• Ependymoma(30-60%): *cellular *papillary *clear cell ependymoma *Tanacytic Anaplastic ependymoma(rare)

• Myxopapillary epenymoma: -most frequent in cauda equina

Subependymoma(cranial)

Chordoma

• Destructive tumor.• Remnant of primitive notochord.• More in male.• In sacrococcygeal 50%.

Spinal PNET

Metastasis

Investigation

• LAB:• Radiological: Plain X ray. CT. MRI.

Treatment

• Surgical:• Chemotherapy• Radiotherapy• Other: Fixation