=====Pediatric spinal cord tumor=====
====Epidemiology====
[[Spinal cord tumor]]s are a relatively rare diagnosis and account for 1% to 10% of all [[pediatric central nervous system tumor]]s
((Hardison HH, Packer RJ, Rorke LB, Schut L, Sutton LN, Bruce DA. Outcome of children with primary intramedullary spinal cord tumors. Childs Nerv Syst. 1987;3:89–92.))
((Stiller CA, Nectoux J. International incidence of childhood brain and spinal tumours. Int J Epidemiol. 1994;23:458–464.))
((Nadkarni TD, Rekate HL. Pediatric intramedullary spinal cord tumors. Critical review of the literature. Childs Nerv Syst. 1999;15:17–28.)).

In children with intramedullary tumors, astrocytomas represent around 60% of tumors, ependymomas 30%, developmental tumors 4%, and then a group of other less frequently identified types
((Nadkarni TD, Rekate HL. Pediatric intramedullary spinal cord tumors. Critical review of the literature. Childs Nerv Syst. 1999;15:17–28.))
((Steinbok P, Cochrane DD, Poskitt K. Intramedullary spinal cord tumors in children. Neurosurg Clin N Am. 1992;3:931–945.)).
====Case series====
The medical records of 36 patients with [[spinal cord tumor]]s were reviewed for clinical, radiological and histopathological data, chemotherapy, radiotherapy, surgical resection, treatment responses, events, and final outcome. Survival analyses were performed.

The median age was 7.9 years (range: 1-16 years; male/female ratio:1.4). Majority of the tumors were histopathologically diagnosed as [[spinal cord astrocytoma]]s (n = 16, 44.4%) and [[spinal cord ependymoma]]s (n = 19, 52.8%); whereas one was unclassified glioma. Overall, 94% of the astrocytomas and 84% of the ependymomas were low-grade, only three tumors were high-grade. In one patient with ependymoma, histopathological grade was undetermined. The primary tumor was commonly located in thoracic (47%) and cervical segments (28%). All patients had undergone surgery (gross-total resection, 33%; subtotal resection, 45%; biopsy, 22%). Radiotherapy was administered to 26 patients (72%) and chemotherapy to 15 patients (42%). The 3-, 5- and 10-year overall survival rates were 72%, 63% and 56%, respectively; and event-free survival rates were 43%, 40% and 40%. Survival did not significantly differ with gender, age groups, lag-time, neurologic status, histopathological tumor type, tumor location, extent of resection, treatment, or treatment responses in univariate survival analyses. Survival rates were significantly higher in patients with low-grade tumors and in ependymoma patients with resected tumors.

Patients with low-grade tumors and those who underwent gross-total tumor resection had better prognosis. Surgery remains the main treatment in intramedullary spinal tumors. The role of radiotherapy and chemotherapy is limited and even controversial in low-grade tumors
((Kutluk T, Varan A, Kafalı C, Hayran M, Söylemezoğlu F, Zorlu F, Aydın B,
Yalçın B, Akyüz C, Büyükpamukçu M. Pediatric intramedullary spinal cord tumors: a
single center experience. Eur J Paediatr Neurol. 2015 Jan;19(1):41-7. doi:
10.1016/j.ejpn.2014.09.007. Epub 2014 Oct 6. PubMed PMID: 25457509.
)).
----
Nine patients, 16 years of age or younger with primary [[spinal cord tumor]]s, diagnosed between 1991 and 2003 at The Kaohsiung University Hospital, were reviewed retrospectively. There were 2 female and 7 male patients. Two tumors were located primarily in the cervical cord (1 meningioma, 1 neurofibroma), five were predominantly thoracic (1 lymphoma, 1 meningioma, 1 astrocytoma, 1 fibrosarcoma and 1 osteoblastoma), one lumbar (ependymoma), and one sacral (Ewing's sarcoma). The most common clinical presentation was limb weakness (100%) followed by back pain (44.4%). All the patients underwent laminectomy for removal of their tumors. Five children with benign tumors improved postoperatively. At discharge, these 5 children could walk without assistance and have remained stable with long-term of follow-up. Radical surgery should be considered in benign primary spinal cord tumors. As would be expected, patients diagnosed and treated early and in whom a total resection was achieved had a better prognosis
((Loh JK, Lin CK, Hwang YF, Hwang SL, Kwan AL, Howng SL. Primary spinal tumors
in children. J Clin Neurosci. 2005 Apr;12(3):246-8. PubMed PMID: 15851074.
)).