Spinal tumors rarely occur and are either benign or malignant. Some tumors are known to metastasize (spread) via arteries, veins and the lymphatic system. Malignant tumors of the breast, prostate, lung and kidney can spread into the spine. Spinal tumors can be dangerous when they cause spinal canal compression, which may lead to neurologic dysfunction, e.g., paralysis.
Noncancerous (Benign) Spinal Tumors
Osteochondroma is a slow growing tumor of the cartilage usually affecting adolescents. It is uncommon and is usually found in the posterior (rear) spine.
Osteoid osteoma is a small bone tumor (less than 0.8 inches). It usually affects adolescents causing night pain and may result in spinal deformity.
Osteoblastoma affects children and adolescents. These tumors can be large, aggressive, and painful sometimes causing spinal deformity and paralysis.
Aneurysmal bone cysts (ABCs) typically cause pain and swelling usually affecting children and adolescents. These tumors can be large and vascular.
Giant cell tumor is known to affect children, adolescents and young adults. These tumors can be found at the cervical, thoracic or lumbar segments of the spine, but are more common in the sacrum.
Hemangioma occurs most often in the thoracic spine. These tumors affect adults and are known to be progressive vascular masses that can cause vertebral collapse and paraparesis (slight paralysis).
Eosinophilic granuloma is usually seen in the vertebral bodies of children and adolescents. When this tumor is systemic, it is termed Histiocytosis X. Rarely do these tumors lead to vertebral collapse. On occasion, they may heal spontaneously.
Malignant Spinal Tumors
What are the symptoms?
Plasmacytoma presents in middle aged and older adults. These tumors are common in the pedicle and vertebral body and may cause paraparesis.
Ewing’s sarcoma is an aggressive tumor affecting adolescents and young adults. In some cases, it may metastasize.
Lymphoma is a cancer of the lymphatic system, the body’s disease-fighting network. It may be present in one or more vertebral bodies in middle aged or older adults. Sometimes the lymphatic system is involved. The lymphatic system includes the lymph nodes (glands), spleen, thymus gland and bone marrow. Lymphoma can affect all those areas as well as other organs throughout the body.
Chondrosarcoma is a tumor affecting spinal cartilage in middle-aged adults. It grows slowly but can be dangerous. Usually aggressive medical intervention is required.
Osteosarcoma is bone cancer found in adolescents and middle-aged adults. These tumors may spread to other parts of the body and require aggressive medical therapy.
Chordoma, usually seen in adults, frequently (50 percent of the time) involving the sacrum (the bone found in the base of the spinal column), although it can affect other parts of the spine. These tumors often require aggressive medical therapy.
Spine pain does not always indicate tumor presence. However, early medical intervention is always recommended if spine pain does not resolve or if neurologic deficit is experienced. Back pain is often seen as the primary symptom. The pain can occur at rest, be worse at night, and may or may not be related to activity. Other symptoms may include sciatica, numbness, paraparesis (slight paralysis), spinal deformity (e.g. scoliosis, kyphosis) and fever.
What are the treatment options?
If any tumor is found in the spine (and there is no other known cancer), a complete examination of all common organs where cancer develops is usually required. Evaluation may include complete medical history, complete physical exam, complete neurological exam, radiographic studies of the spine, chest and GI systems for tumors, and MRI and CAT scans.
Nonsurgical options are considered first-line treatment for many metastatic spinal tumor symptoms and tumor management. Nonsurgical options vary from medications to radiation therapy. Pain medications are typically prescribed at the onset of back pain. Other medications may be prescribed to treat other side effects of metastatic spine tumors. Back braces may also be used for symptom relief when mechanical pain develops as a result of spinal instability. Braces are often used in conjunction with other treatments.
Certain medication, radiation, ablation and chemotherapy treatments all aim to shrink and/or destroy tumor cells for pain relief. Surgical removal of a spine tumor is indicated for patients who may benefit from the tumor removal, either in terms of removing the cancer and/or lessening any severe symptoms associated with the tumor. There are many types of surgery that may be considered as part of treatment for a spinal tumor. In general, there are two categories of surgery: minimally invasive surgery (surgical approaches that include relatively small incisions) and open surgery (more extensive surgical procedures that require larger incisions).
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