Spinal Cord Tumors

Types of Spinal Cord Tumors

Schwannoma and Neurofibroma (nerve sheath tumors)

Nerve sheath tumors develop from the cells that surround nerves. Men and women are equally affected. Most patients are between the ages of 30 and 50. Schwannomas and neurofibromas account for about 25 percent of intradural (inside the spinal canal) spinal cord tumors in adults. Most are single schwannomas that can occur throughout the spinal canal. Neurofibromas usually occur as part of neurofibromatosis, a genetic disorder often associated with multiple neurofibromas.

Only 2.5 percent of intradural spinal nerve sheath tumors are malignant. At least one half of these occur in patients with neurofibromatosis.

Benign nerve sheath tumors are surgically removed if they are causing symptoms such as pain, numbness or weakness. Recurrences are rare if tumors are totally removed. Malignant tumors may require additional treatment with radiation or chemotherapy.

Ependymoma

Ependymomas develop from ependymal cells. They are most often seen in adults 20 to 40 years old.

Spinal cord ependymoma

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This relatively common and usually slow-growing tumor accounts for more than half of adult spinal cord tumors. Ependymoma can develop anywhere along the spinal cord, but up to 40 percent are found near the tailbone.

Symptoms vary depending on the tumor's location. Pain is the most common symptom.

Surgery is the preferred treatment, sometimes followed by radiation therapy if total surgical removal is not possible, or if the tumor appears to be growing rapidly.

Meningiomas

Meningiomas are usually slow-growing tumors that develop from the meninges, the protective linings of the brain and spinal cord. They occur most often in the thoracic (center) region of the spine, although they can also occur in the cervical region and, rarely, the lumbar (lower) region.

Symptoms may develop gradually over time and can include sensory changes, difficulty walking, back pain, weakness, and bladder or bowel problems.

Most meningiomas are benign and may not require surgical removal. With successful removal, symptoms usually diminish or disappear.

Although meningiomas occur less frequently in younger patients, a Mayo Clinic study reported that those found in younger patients (under 50 years old) were more likely to be aggressive and to be located in the cervical spine. The tumors were also more often associated with neurofibromatosis type 2 (NF2), previous radiation exposure, or trauma compared to tumors found in older patients. Although the tumors were still usually removed with successful results, they had a higher rate of recurrence. Read the abstract of this study on PubMed.

Due to their greater tendency to recur, meningiomas in younger patients need vigilant follow-up. Mayo Clinic's multispecialty team approach to diagnosis, treatment and care provides high-quality, integrated long-term care for each patient.

Astrocytomas

Astrocytomas develop from cells called astrocytes found within the spinal cord.

Spinal cord astrocytoma

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These tumors occur at any age, but are more common during the early years of life. In children under 10, astrocytomas account for 90 percent of all intramedullary (inside the spinal cord) tumors. In adolescents, they account for about 60 percent of all intramedullary tumors. Most astrocytomas are located in the spinal cord near the neck and upper chest.

Symptoms vary with the location of the tumor and may develop over two to three years if the tumor is slow growing. High-grade, more aggressive tumors develop more rapidly, within a few weeks or months.

Surgery is an effective treatment for astrocytomas, especially those with well-defined borders. However, astrocytomas are more difficult to remove totally than most other spinal cord tumors. Tumors that cannot be totally removed or appear to be developing rapidly usually require radiation therapy after surgery.

Follow-up care is coordinated by a team of experts headed by a neuro-oncologist who oversees long-term management of patients with astrocytomas. Mayo's unique approach brings together specialists to provide the most appropriate comprehensive care and continuity of care for each patient.

Spinal cord hemangioblastomas in a patient with von Hippel-Lindau disease

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Hemangioblastoma

Hemangioblastomas are benign tumors; they do not threaten life or health. They usually have well-defined edges and can occur at any age. Most often, they are seen in adults 30 to 50 years old, and more often in men than women. Hemangioblastomas are relatively rare in children.

Hemangioblastomas account for about 5 percent of intramedullary tumors. Fifteen to 25 percent occur in association with von Hippel-Lindau disease, a rare inherited disorder.

Hemangioblastomas are often associated with a cyst within the spinal cord. Early symptoms are usually nonspecific and may progress slowly.

Surgery is the preferred treatment and generally provides long-term tumor control or cure for hemangioblastomas.

Anatomical classification of spinal tumors

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Anatomical Classification

Spinal tumors can be classified based on anatomical features. The image at right describes tumors based on their location and growth.