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Lumbar Spinal Cord Tumor
Spinal Cord Tumor Lumbar

Presentation

They typically present in patients in the fourth decade of life and have a male predominance. Osteosarcomas are most common in the lumbosacral segments. Patients often present with pain and a palpable mass. [patient.info]

The present study reports a case of easily misdiagnosed delayed metastatic intraspinal extradural melanoma of the lumbar spine. A 67‑year‑old female patient presented with lower back pain accompanied by progressive intermittent claudication. [spandidos-publications.com]

Contrast enhancement is generally present and is usually heterogeneous. [appliedradiology.com]

They present as enhancing masses and will not cause a differential problem. All other cord tumors are uncommon. The images are of a patient with neurofibromatosis who has multiple ependymomas. They present as multiple enhancing masses. [radiologyassistant.nl]

Most patients with spinal metastatic cancer will present to the physician’s office with either involvement of the spinal cord and nerve endings, or the vertebral column bones. [spinemd.com]

Entire Body System

  • Difficulty Walking

    Some common signs of spinal tumors may include: Pain (back and/or neck pain, arm and/or leg pain) Muscle weakness or numbness in the arms or legs Difficulty walking General loss of sensation Difficulty with urination (incontinence) Change in bowel habits [cancercenter.com]

    walking that may lead to falls Muscle contractions or spasms Sometimes paralysis Diagnosis of Spinal Cord Tumor Spinal cord tumors may sometimes go unnoticed as its symptoms resemble various other disorders. [thebrainandspine.com]

    Difficulty walking is sometimes a complaint. What are the medical/interventional (nonsurgical) treatment options? The nonsurgical options for treating spinal tumors include observation, chemotherapy and radiation therapy. [spine.org]

    Back pain is one of the most common symptoms, but there are others including: Muscle weakness or loss of feeling in arms or legs Difficulty walking or clumsiness and falling Decreased sensitivity to pain as well as hot and cold temperatures Loss of bowel [rushortho.com]

    Signs and symptoms may include: Pain at the site of the tumor due to tumor growth Back pain, often radiating to other parts of your body Feeling less sensitive to pain, heat and cold Loss of bowel or bladder function Difficulty walking, sometimes leading [mayoclinic.org]

  • Pathologist

    The removed tissue is sent to a pathologist (a doctor specializing in diagnosis of diseases by lab tests). Sometimes it might need to be looked at by a neuropathologist, a pathologist who specializes in nervous system diseases. [cancer.org]

    To help make a diagnosis of poorly differentiated chordoma, a pathologist can test a tumor sample for loss of expression of a protein called INI1. [chordomafoundation.org]

    A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor may remove as much tumor as safely possible during the same surgery. [cancer.gov]

    After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis Note: Spinal Schwannomas are usually not of plexiform histological pattern; plexiform schwannoma [dovemed.com]

Musculoskeletal

  • Back Pain

    Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. J Bone Joint Surg Am. 2006;88 Suppl 2:21. Patel AT, Ogle AA. Diagnosis and management of acute low back pain. [cancercarewny.com]

    Therefore, the doctor’s challenge is to determine how to evaluate back pain with the goal of specifically excluding a tumor as the cause of the pain. Luckily, most back pain is not due to a tumor. [pbbsneuro.com]

    When to see a doctor There are many causes of back pain, and most back pain isn't caused by a tumor. [mayoclinic.org]

    Symptoms progressively improved and, six weeks later the patient was without symptoms and the straight leg raising test no longer produced sciatic pain but did produce back pain. [healio.com]

    View/Print Figure Low Back Pain FIGURE 1. Suggested approach to the initial assessment of the patient with acute low back pain. (CT = computed tomographic; MRI = magnetic resonance imaging) Adapted from Bigos SJ, et al. [aafp.org]

  • Low Back Pain

    Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. J Bone Joint Surg Am. 2006;88 Suppl 2:21. Patel AT, Ogle AA. Diagnosis and management of acute low back pain. [cancercarewny.com]

    View/Print Figure Low Back Pain FIGURE 1. Suggested approach to the initial assessment of the patient with acute low back pain. (CT = computed tomographic; MRI = magnetic resonance imaging) Adapted from Bigos SJ, et al. [aafp.org]

    Case Report History A 32 year old man was referred for consultation after three months of conservative treatment had failed to relieve low back pain with left sciatic pain to the toes. He denied any bowel orbladder control problems. [healio.com]

  • Acute Low Back Pain

    References: Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 22, 2013. Accessed November 26, 2013. Bratton RL. Assessment and management of acute low back pain. [cancercarewny.com]

    Suggested approach to the initial assessment of the patient with acute low back pain. (CT = computed tomographic; MRI = magnetic resonance imaging) Adapted from Bigos SJ, et al. Acute low back problems in adults. Rockville, Md.: U.S. [aafp.org]

  • Spine Pain

    pain that is worse in the morning Pain that is severe when there is direct manipulation or compression of the affected area of the spine Pain that does not diminish with rest, and pain that may be worse at night than during the day Back pain along with [spine-health.com]

    The type of pain can provide important information about the tumor. Pain mainly when you sit or stand usually means that the tumor is causing weakness or instability in the bones of your spine. [mskcc.org]

  • Neurogenic Claudication

    These degenerative changes can be superimposed on a congenitally narrow canal. 18 [ corrected ] Lumbar spinal stenosis may result in neurogenic claudication. In this condition, leg pain is brought on by walking and is relieved by sitting. [aafp.org]

Neurologic

  • Tingling

    When the tumor presses on the spinal cord, symptoms may begin with numbness or tingling in the arms or legs. Next, patients may experience clumsiness, not knowing where their feet are, and difficulty with buttons or keys. [cancercenter.com]

    The numbness and tingling is just a side effect I will have to live with for now.. it may improve with time and let’s hope so. [djohnston05blog.wordpress.com]

    […] cells in the nerves, bones, or cartilage of the spine Exposure to radiation and chemicals Hereditary – Neurofibromatosis is a tumor of the spinal nerves People with spine tumors may experience persistent and chronic back pain, numbness, burning and tingling [southerncaliforniaspinesurgery.com]

    Symptoms Spinal cord compression can cause numbness and tingling, weakness, difficulty with urinating or bowel movements, incontinence, and stiffness of the extremities. Treatment A laminectomy is performed to gain access to the spinal cord. [neurosurgery.ucla.edu]

    These can take the form of numbness, tingling, decreased sensitivity to temperature or cold sensations. Motor problems. [drugs.com]

  • Sciatica

    Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010;(6):CD007612. Hagen KB, Hilde G, et al. Bedrest for acute low back pain and sciatica. [cancercarewny.com]

    Neurosurgery and Emergency Care Intracranial Hemorrhage Spinal Cord Injury Spine Fractures Traumatic Brain Injury SPINE Cervical, Thoracic, and Lumbar Degenerative Spine Disease Degenerative Disc Disease Foraminal Stenosis Herniated Disc Radiculopathy Sciatica [vaneurosurgeons.com]

    Neurological examination revealed a positive Laséque's sign, which distinguishes sciatica from disease of the hip joint, weakness of the extensor hallucis longus and decreased ankle reflex in his right lower extremity. [nature.com]

  • Paresthesia

    Reduced sensory function Cold sensation in the lower limbs Cold, clammy skin Incontinence, both urinary and fecal Paresthesia (burning, prickling, itching, or tingling of the skin) especially on the lower limbs Paralysis Spinal Cancer Causes The cause [cancerwall.com]

    The patient should be asked about paresthesias, numbness or weakness. Muscle weakness, if progressive, must be evaluated urgently. [aafp.org]

  • Dizziness

    People with an ependymoma in the brain may have headaches, nausea, vomiting and dizziness. [cern-foundation.org]

    […] spinal tumors, see your doctor about your back pain if: It's persistent and progressive It's not activity related It gets worse at night You have a history of cancer and develop new back pain You have other symptoms of cancer, such as nausea, vomiting or dizziness [mayoclinic.org]

  • Decreased Ankle Reflex

    Neurological examination revealed a positive Laséque's sign, which distinguishes sciatica from disease of the hip joint, weakness of the extensor hallucis longus and decreased ankle reflex in his right lower extremity. [nature.com]

Urogenital

  • Urinary Incontinence

    Urinary incontinence is often associated with a syrinx when the lesion causes disruption of the sacral pathways. Sexual dysfunction may also occur in association with loss of sphincter control. [neurospinewi.com]

  • Overflow Incontinence

    When the tumor causes pressure on the second or third sacral nerve roots, micturition is affected and there is paralysis of bladder contractions, bladder distention, and retention of urine with overflow incontinence. [neurospinewi.com]

Workup

Electrodiagnostics: Electrical testing of the nerves and spinal cord may be performed as part of a diagnostic workup. [libertyspinecare.com]

Treatment After diagnostic workup, spinal cord edema (swelling) should be managed preoperatively with oral or IV steroids. Edema is most commonly managed with a corticosteroid such as Decadron (dexamethasone). [neurospinewi.com]

• INTRODUCTION • ANATOMY • EPIDEMILOGY • NATURAL HISTORY • CLASSIFICATION • ROUTES OF SPREAD • CLINICAL PESENTATION • DIAGNOSTIC WORKUP • PROGNOSTIC FACTOR • DISEASE SPECIFIC MANAGEMENT • CONCLUSION Dodul Mondal 3. [slideshare.net]

Treatment

Treatment for children is usually different than treatment for adults. (See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information about the treatment of adults.) [cancer.gov]

Treatment is decompression, with specific treatment for the individual tumor. The intradural-extramedullary tumors comprise about 35% of spinal canal tumors. Meningiomas and neurofibromas are most frequently encountered. [healio.com]

Your radiotherapy team use this scan to plan your treatment. At the beginning of each treatment session, you lie in the same position but under the radiotherapy machine. The treatment itself only takes a few minutes. [macmillan.org.uk]

Treatment is key for spinal tumours, as any damage it causes can be made more severe or indeed, permanent, if treatment is not sought soon enough. [spinalcord.com]

Prognosis

– Symptoms, Survival Rate & Prognosis [cancerwall.com]

Prognosis of Meningioma of the Spinal Cord Benign meningiomas are associated with a very good survival prognosis with approximately 100% 5 year survival. [myvmc.com]

Prognosis The prognosis varies depending on the nature of the tumor cells, their aggressiveness and the sensitivity of the tumor to radiation and chemotherapy. [spinehealth.com]

What is the Prognosis of Spinal Schwannoma? (Outcomes/Resolutions) The prognosis of Spinal Schwannoma (benign tumor) is excellent, if the tumor can be removed without damaging the underlying nerve. [dovemed.com]

- Metastatic Tumors of the spine: - carcinoma of the breast, kidney, or multiple myeloma may have relatively good long term prognosis; - metastatic carcinoma of the prostate or lung may have poor 1 year survival; - patients w/ combination of spinal [wheelessonline.com]

Etiology

(Etiology) The exact cause and mechanism of Spinal Schwannoma formation, in a majority of cases, is unknown; they are known to be the result of sporadic mutations. This implies that they do not have a preceding family history of the condition. [dovemed.com]

Etiology and Pathophysiology: Spinal cord tumors can be primary or metastatic. [neurospinewi.com]

[…] associated finding • Majority of intramedullary neoplasms show at least some enhancement • Contrast study essential: Enhancement useful in focal masses, especially hemangioblastoma and mets Contrast helpful in differentiating suspected neoplasms from other etiologies [slideshare.net]

Epidemiology

Currently, the Surveillance Epidemiology and the End Results (SEER) Program and the Central Brain Tumor Registry (CBTRUS) group all grades of ependymomas together for reporting purposes. [cern-foundation.org]

Primary spinal cord glioma: a Surveillance, Epidemiology, and end results database study. J Neurooncol2010;98(1):83–92 Dodul Mondal 18. [slideshare.net]

They provide comprehensive information about the diagnosis, treatment, epidemiology, and prognostic factors of chordoma: Building a global consensus approach to chordoma: a position paper from the medical and patient community Chordoma: current concepts [chordomafoundation.org]

Pathophysiology

Etiology and Pathophysiology: Spinal cord tumors can be primary or metastatic. [neurospinewi.com]

Prevention

BACKGROUND: Postoperative cerebrospinal fluid (CSF) leakage is a major clinical problem, and prevention of CSF leakage at the surgical site is an important issue. [ncbi.nlm.nih.gov]

Prevention Although spinal cord tumors cannot be prevented, some forms of cancer that spread to the spinal cord can be prevented or cured before they can spread to the spine. [drugs.com]

Prompt intervention may prevent paralysis. [medical-dictionary.thefreedictionary.com]

The main priority is to administer treatment as quickly as possible to prevent progression. The three most commonly used treatments are surgery, radiation, and chemotherapy. [libertyspinecare.com]

You can prevent some tumors by maintaining a healthy lifestyle. We do not know a lot about preventing spine tumors. Early detection of a spine tumor is the best known step to successful treatment. [mountsinai.org]

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