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
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