Early diagnosis can be an important factor in the outcome of tumors in the spinal cord. Primary spinal cord tumors — tumors that originate in the spine rather than spread to the spine from elsewhere in the body — are usually benign. They are so rare that they account for only a half of one percent of all newly diagnosed tumors. Malignant primary tumors of the spinal cord are even less common.
Most spinal cord cancers are metastatic or secondary cancers, meaning they arise from cancers that have spread to the spinal cord. Cancers that may spread to the spine include lung, breast, prostate, head and neck, gynecologic, gastrointestinal, thyroid, melanoma, renal cell carcinoma and others.
Tumors within the spinal cord generally cause detectable symptoms, while spinal tumors outside of the cord may develop for some time before symptoms emerge. Common symptoms include:
The first test to diagnose brain and spinal column tumors is a neurological examination. Special imaging techniques such as computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) are also performed.
Laboratory tests include the electroencephalogram (EEG) and the spinal tap. A biopsy, a surgical procedure in which a sample of tissue is taken from a suspected tumor, helps doctors diagnose the type of tumor.
While surgery is increasingly recommended for benign and malignant primary spinal cord tumors, the role of surgery in spinal metastasis, or cancer that has spread to the spine, is controversial. Recent developments in imaging as well as new surgical tools and techniques, such as ultrasonic aspirators and lasers, have significantly expanded the role of surgery as an intervention.
For metastatic tumors with spinal cord compression, some neurosurgeons may perform surgery in selected patients to relieve pressure and pain, reconstruct or stabilize the spine, preserve mobility and bowel and bladder function, and to maximize quality of life. Some doctors may only recommend surgery for patients with a single metastatic tumor and no evidence of cancer growing at another site.
Reviewed by health care specialists at UCSF Medical Center.
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