Spinal cord tumor classification

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Advances in molecular pathology have resulted in better understanding and categorization of CNS tumors, leading to better decision-making on the most appropriate therapeutic approach for each category, as well as proposing new therapeutic modalities to treat these tumors ¹⁾.

They can be classified according to many ways:

see Primary spinal cord tumor

Adult spinal cord tumor.

Pediatric spinal cord tumor.

Cervical spinal cord tumor

Thoracic spinal cord tumor

Intramedullary spinal cord tumor.

Intradural extramedullary spinal tumor.

glial neoplasms : 90 - 95% of all intramedullary tumours

Spinal cord ependymoma : 60% of all glial spinal cord tumours

Spinal cord astrocytoma : 33% of all glial spinal cord tumours

Spinal cord ganglioglioma : 1% of all glial spinal cord tumours

non-glial neoplasms

highly vascular lesions

Spinal cord hemangioblastoma

spinal paraganglioma

other rare lesions :

Intramedullary spinal cord metastasis

primary lymphoma of the spinal cord

Spinal primitive neuroectodermal tumor

solitary fibrous tumour

intramedullary benign masses

spinal canal epidermoid cyst

Spinal cord lipoma

Intramedullary spinal neoplasms are more common in patients with neurofibromatosis:

ependymomas occur more often in patients with NF2

astrocytomas occur more often in patients with NF1.

Approximately 70% of intramedullary tumours are associated with cysts.

Two types of cysts are recognised :

tumoural (or intratumoural) cysts

contained within the tumour itself

typically demonstrate peripheral enhancement

may result from necrosis, fluid secretion, or degeneration of the neoplasm

need to be resected along with the solid portion of the tumour because there is a high likelihood of neoplastic cells within the cyst wall

occurs in association with the following proportion of tumours:

spinal ganglioglioma : in 46%

spinal ependymoma : in 22%

spinal astrocytoma : in 21%

spinal hemangioblastoma : in 2 - 4%

non-tumoural (or reactive) cysts

occur rostral or caudal to the solid portion of the tumour

occur due to dilatation of the central canal

do not enhance

present in 60% of all intramedullary spinal tumours may resolve once the neoplasm is resected

Syringomyelia occurs in approximately 50% of all intramedullary tumours but is most frequently associated with spinal cord hemangioblastomas.