Intradural extramedullary spinal canal secondary neoplasms: MR findings in 30 patients

Frey, Isabelle; Breton, C. Le; Lefkopoulos, A.; Perrot, Nicolas; Khalil, Antoine; Chopier, J.; Blanche, Alain-Ferdinand Le; Bigot, Jean-Michel

doi:10.1007/s003300050532

Cited by 35 publications

(26 citation statements)

References 15 publications

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“…However, according to previous articles, malignant tumors, such as secondary neoplasms, primitive neuroectodermal tumors, and malignant intramedullary astrocytomas, appear within CM and CE more frequently than in the upper regions of the spine. 5,10,11,13,14 According to our results and to previous data, in the majority of cases CECMTs are associated with very unspecific symptoms, such as low-back pain or sciatica, mimicking other more common degenerative lumbar spine diseases. 3,13,16,21 As long as no functional neurological deficit is observed, these symptoms are usually treat- ed conservatively, with health care professionals refraining from the use of imaging diagnostics.…”

Section: Natural History and Presentationsupporting

confidence: 82%

Conus medullaris and cauda equina tumors: clinical presentation, prognosis, and outcome after surgical treatment

Wostrack¹,

Shiban²,

Obermueller³

et al. 2014

SPI

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Spinal tumors are uncommon lesions that affect only a minority of the population. They are most often located extradurally (60% of all spinal tumors), with the majority originating in the vertebrae. 25 Primary intradural tumors-that is, tumors of the spinal cord, the meninges, and the cauda equina-are exceptionally rare, appearing with an age-adjusted incidence of 0.97 per 100,000 persons per year 6 and comprising 10%-20% of primary CNS neoplasms. 19 The most frequent location of intradural spinal tumors is the cervical and thoracic spine. 4,7,20 Less commonly, these lesions appear within the conus medullaris (CM), comprising approximately 10% of intramedullary spinal cord tumors, 11 or at the level of the cauda equina (CE), representing about 6% of spinal intradural tumors. 3,13,21 Because patients frequently have nonspecific symptoms, intradural CE and CM tumors (CECMTs) can remain misdiagnosed for long periods of time. Due to the rarity of these lesions, the number of pertinent studies in the literature concerning clinical and prognostic data is relatively low. Only a few authors have described intradural spinal tumors in this specific location as separate clinical series. 3,9,11,13,16,18,21 Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, GermanyObject. Intradural cauda equina and conus medullaris tumors (CECMTs) are rare. Only a few large clinical series exist to date. Therefore, clinical symptoms, surgical complications, and outcomes are poorly understood. The aim of the present study was to evaluate outcome after surgery of CECMTs and to identify the factors associated with a worse clinical prognosis based on the results of a series with sufficiently high number of cases.Methods. All cases of intradural CECMTs treated surgically at the authors' department between March 2006 and May 2012 were retrospectively evaluated. Arachnoid cysts and multifocal tumors were excluded. Sixty-eight adult patients met the inclusion criteria (35 female and 33 male patients; median age 56 years). Follow-up data were available for 72% (n = 49) in a median period of 9 months.Results. Overall, 18 tumors were located intramedullary and 50 extramedullary. The majority were nerve sheath tumors (n = 27), ependymomas (n = 17), and meningiomas (n = 9). The most common preoperative symptom was pain. The rate of new transient postoperative impairment was 18% (n = 12), and new permanent deficits were observed in only 6% (n = 4). Overall neurological improvement was achieved in 62%. The reversibility of preoperative symptoms was related to the interval between the time of symptom onset and the time of surgery and to the presence of preoperative neurological deficits. Surgery of ependymoma and carcinoma metastases was associated with a higher rate of morbidity.Conclusions. Intradural CECMTs present as a group of tumors with varying histological features and clinical symptoms. Symptomatic manifestation is usually unspecific, mimicking degenerative lumbar spine syndromes. Despite a significant risk of t...

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Section: Natural History and Presentationsupporting

confidence: 82%

Conus medullaris and cauda equina tumors: clinical presentation, prognosis, and outcome after surgical treatment

Wostrack¹,

Shiban²,

Obermueller³

et al. 2014

SPI

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“…These tumors almost always involve the vertebral column and/or extradural space. The spinal intradural compartment is involved in only 0.5%-6% of metastases [3,6,9,[12][13][14][15]. While there are numerous studies highlighting the incidence and treatment of extradural spinal metastases, there is little information regarding intradural spinal metastases.…”

Section: Introductionmentioning

confidence: 96%

Intradural spinal metastases: a surgical series of 15 patients

2012

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“…Cases have been reported from adenocarcinoma of the lung, the breast, and rarely from the esophagus. [1][2][3] The majority of cauda equina tumors are primary tumors of glial or nerve sheath origin. However, metastases from outside of the central nervous system in this region are very rare.…”

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confidence: 99%