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Review
. 2015 Oct;5(5):425-35.
doi: 10.1055/s-0035-1549029. Epub 2015 Mar 31.

Intramedullary Spinal Cord Tumors: Part I-Epidemiology, Pathophysiology, and Diagnosis

Dino Samartzis  1 , Christopher C Gillis  2 , Patrick Shih  3 , John E O'Toole  2 , Richard G Fessler  2
Affiliations
Review

Intramedullary Spinal Cord Tumors: Part I-Epidemiology, Pathophysiology, and Diagnosis

Dino Samartzis et al. Global Spine J. 2015 Oct.

Abstract

Study Design Broad narrative review. Objectives Intramedullary spinal cord tumors (IMSCT) are rare neoplasms that can potentially lead to severe neurologic deterioration, decreased function, poor quality of life, or death. As such, a better understanding of these lesions is needed. The following article, part one of a two-part series, addresses IMSCT with regards to their epidemiology, histology, pathophysiology, imaging characteristics, and clinical manifestations. Methods The authors performed an extensive review of the peer-reviewed literature addressing the aforementioned objectives. Results Numerous IMSCT exist with varying epidemiology. Each IMSCT has its own hallmark characteristics and may vary with regards to how aggressively they invade the spinal cord. These lesions are often difficult to detect and are often misdiagnosed. Furthermore, radiographically and clinically, these lesions may be difficult to distinguish from one another. Conclusions Awareness and understanding of IMSCT is imperative to facilitate an early diagnosis and plan management.

Keywords: astrocytoma; cord; ependymoma; epidemiology; intradural; intramedullary; spinal; tumors.

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Conflict of interest statement

Disclosures Dino Samartzis, none Christopher C. Gillis, none Patrick Shih, none John E. O'Toole, none Richard G. Fessler, none

Figures

Fig. 1
Fig. 1
(A) Sagittal T1-weighted post–gadolinium contrast cervical magnetic resonance image (MRI) noting a heterogeneously enhancing intramedullary astrocytoma (arrow). (B) Sagittal T2-weighted cervical MRI demonstrating an intramedullary astrocytoma (arrow). (C) Axial T1-weighted post–gadolinium contrast cervical MRI illustrating a cystic astrocytoma; the cystic portions are highlighted by arrows and are hypointense compared with the enhancing surrounding rim.
Fig. 2
Fig. 2
(A) Sagittal T1-weighted post–gadolinium contrast cervical magnetic resonance image illustrating the presence of a homogeneously enhancing ependymoma at the levels of C5 and C6 (arrow). (B) Corresponding axial view noting the centromedullary location of the ependymoma (arrow).
Fig. 3
Fig. 3
Sagittal T1-weighted post–gadolinium contrast lumbar magnetic resonance image illustrating the presence of a homogenously enhancing ependymoma at the levels of L1 and L2 (arrow).
Fig. 4
Fig. 4
(A) Sagittal T1-weighted post–gadolinium contrast magnetic resonance image noting an avidly homogenous enhancing nodule representing a hemangioblastoma at the level of T2–T3 (arrow). (B) Corresponding axial view noting the involvement of the tumor in relation to the cord (arrow).
See this image and copyright information in PMC

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