Editing Spinal tumor (section)

{{Short description|Neoplasms located in either the vertebral column or the spinal cord}}

'''Spinal tumors''' are [[neoplasm]]s located in either the [[vertebral column]] or the [[spinal cord]].<ref name=":0">{{Cite book |editor1-last=Arnautović |editor1-first=Kenan I. |editor2-last=Gokaslan |editor2-first=Ziya L. |year=2018 |title=Spinal Cord Tumors |location=Cham, Switzerland |publisher=Springer |isbn=978-3-319-99438-3 |oclc=1084270205}}</ref> There are three main types of spinal tumors classified based on their location: extradural and intradural (intradural-intramedullary and intradural-extramedullary). Extradural tumors are located outside the [[dura mater]] lining and are most commonly [[Metastasis|metastatic]].<ref name=":3">{{Citation|last1=Gossman|first1=William|title=Cancer, Intramedullary Spinal Cord Tumors|date=2019|url=http://www.ncbi.nlm.nih.gov/books/NBK442031/|work=StatPearls|publisher=StatPearls Publishing|pmid=28723060|access-date=2019-12-03|last2=Hoang|first2=Stanley|last3=Mesfin|first3=Fassil B.}}</ref> Intradural tumors are located inside the dura mater lining and are further subdivided into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the dura and spinal cord parenchyma, while intradural-extramedullary tumors are located within the dura but outside the spinal cord parenchyma. The most common presenting symptom of spinal tumors is nocturnal back pain.<ref name=":0" /> Other common symptoms include [[muscle]] weakness, sensory loss, and difficulty walking.<ref name=":0" /> Loss of bowel and [[Urinary bladder|bladder]] control may occur during the later stages of the disease.<ref name=":4">{{Cite journal|last=Balériaux|first=D. L. F.|date=1999-08-01|title=Spinal cord tumors|journal=European Radiology|language=en|volume=9|issue=7|pages=1252–1258|doi=10.1007/s003300050831|pmid=10460357|s2cid=6586168|issn=1432-1084}}</ref>

The cause of spinal tumors is unknown. Most extradural tumors are metastatic commonly from breast, prostate, lung, and kidney cancer.<ref name=":1">{{Citation|last1=Burton|first1=Matthew R.|title=Cancer, Conus and Cauda Equina Tumors|date=2019|url=http://www.ncbi.nlm.nih.gov/books/NBK441878/|work=StatPearls|publisher=StatPearls Publishing|pmid=28722908|access-date=2019-12-03|last2=Mesfin|first2=Fassil B.}}</ref> There are many genetic factors associated with intradural tumors, most commonly [[Neurofibromatosis type I|neurofibromatosis 1]] (NF1), [[Neurofibromatosis type II|neurofibromatosis 2]] (NF2), and [[Von Hippel–Lindau disease|Von Hippel–Lindau]] (VHL) syndrome.<ref name=":0" /> The most common type of intradural-extramedullary tumors are [[meningioma]]s and [[Nerve sheath tumor|nerve-sheath tumors]].<ref name=":2">{{Cite web|url=https://www.aans.org/|title=Spinal Tumors – Types, Symptoms, Diagnosis and Treatment|website=www.aans.org|language=en|access-date=2019-12-03}}</ref> The most common type of intradural-intramedullary tumors are [[ependymoma]]s and [[astrocytoma]]s.<ref name=":5">{{Cite journal|last1=Mechtler|first1=Laszlo L.|last2=Nandigam|first2=Kaveer|date=2013-02-01|title=Spinal Cord Tumors: New Views and Future Directions|journal=Neurologic Clinics|series=Spinal Cord Diseases|volume=31|issue=1|pages=241–268|doi=10.1016/j.ncl.2012.09.011|pmid=23186903|issn=0733-8619}}</ref> Diagnosis involves a complete medical evaluation followed by imaging with a CT or MRI. A biopsy may be obtained in certain cases to categorize the lesion if the diagnosis is uncertain.<ref name=":0" /><ref name=":1" /><ref name=":2" />

Treatment often involves some combination of surgery, radiation, and chemotherapy.<ref name=":0" /><ref name=":1" /><ref name=":2" /> Observation with follow-up imaging may be an option for small, benign lesions.<ref name=":1" /> Steroids may also be given before surgery in cases of significant cord compression.<ref name=":0" /> Outcomes depend on a number of factors including whether the tumor is benign or malignant, primary or metastatic, and location of the tumor. Treatment is often [[Palliative care|palliative]] for the vast majority of metastatic tumors.<ref name=":2" />