It is vital that the medical treatment and care of patients diagnosed with a Spinal Tumor are within a Multidisciplinary Team Structure, including a Spinal Tumor Surgeon, Medical Oncologist, and Radiotherapy Oncologist, as well as an experienced and senior Oncology Nursing Team.
Spinal tumours can be described based on their position relative to the spinal cord and the dural sac, which surrounds and protects the spinal cord. Tumours of the bony vertebral column which do not pass through the dural sac but may compress the spinal cord and nerves are called Extradural Spinal Tumors.
Most Extramedullary Spinal Tumors are, unfortunately, metastatic malignant secondary tumours having spread from elsewhere. Commonly breast, prostate, lung, or kidney cancer. Primary Extradural Spinal tumours also occur; some are more benign than others.
Extradural tumours often present with pain of insidious onset and progressive symptoms with the development of neurological symptoms and loss of function with time due to the development of spinal cord and nerve compression. Fractures and mechanical instability of the bony vertebral column can also develop.
In contrast, Intradural Extramedullary Spinal Tumors tend to be benign, resulting in compression of surrounding spinal tissues rather than frank destruction. These tumours, commonly meningiomas or nerve sheath tumours (schwannomas/neurofibromas), also present with insidious onset and progressive symptoms with the development of neurological symptoms and loss of function with time due to the development of spinal cord and nerve compression.
Finally, Intramedullary Spinal Cord Tumors are mainly primary tumours (astrocytomas, ependymomas, and hemangioblastomas). Most but not all of these tumours are lower / intermediate grade (less aggressive in nature), and some, like hemangioblastomas and myxopapillary ependymomas, behave in a benign manner. Their position within the spinal cord tissue makes them challenging despite their often more benign biology.
If a spine tumour is diagnosed, regardless of the type, it is important to follow up with the Multidisciplinary Team to determine the best treatment options.
