Neoplasm | upmcspinespecialists

Malignancy

The spine can develop neoplasm or cancerous growths. The most common malignancy of the spine are metastatic tumors. Because of the rich vascular supply of the spine it is one of the organs of the body that easily develops metastasis in the similar manner as the lungs and the liver. Malignancy arising from the spine is itself is categorized as primary spine tumors. Tumors of the spine can cause compression of the neural elements or destroy the integrity of its architecture.

The common denominator in spine malignancy is inflammation in and around the spine brought about by a growing mass. This leads to the following signs and symptoms.

Pain - is usually very severe and localized
to the involved level. Pain is usually

exaggerated. Patient would wake up

in the middle of their sleep because

of pain. Pain becomes progressively

intense in the evolution of the pathology.

Weakness - subtle signs of weakness due to

compression of the spinal cord and

nerve roots herald a progressively

increasing space occupying lesion.

This usually signifies a breach in the

integrity of the architecture of the

spine. Weakness in spine malignancy

heralds paralysis. Immediate treatment

should be instituted once weakness

develops.

Cauda Equina Syndrome - is a "surgical emergency."

Patients would usually experience severe leg

pains with sudden weakness of both lowers.

There would be an associated urinary or bowel

incontinence. This signifies severe cord

compression that necessitates immediate

decompressive surgery.

Paralysis - is caused by an extension of tumor
mass into the spinal canal causing

cord compression. This condition is

usually irreversible in nature if not

immediately subjected to decompression

procedures. Paralysis invariably happens

early or late in the disease process. Once

patients develop weakness treatment

should be instituted immediately.

Deformity - seldom happens in malignancy.

Patient usually does not live long to

experience deformity once they are

paralyzed. For those who live long

enough after being treated adequately

their spine tumor, deformity is a

consequence of damage to the anatomy

of the spine or weakness brought about

by radiation to the spine.

When considering neoplasms of the spine basic serological exams are needed. Spine infection can usually mimic neoplastic disorders of the spine. Imaging exams may also help in the diagnoses and the demarcation of the geographic extent of the neoplasm. Your spine specialists would normally order one or combination of all these labs to fully evaluate your spine and offer the best management.

               Blood exam -       Complete Blood Count
                                             Erythrocyte Sedimentation Rate
                                             C- Reactive Proteins

Tumor Markers

               Imaging                - X-Rays
                                             - CT Scans
                                             - MRI with contrast medium

This demonstrates how a metastatic tumor can invade the cervical spine. The resulting tumor growth can compromise the spinal canal causing compression of the cord. This can lead to initial symptoms of weakness that quickly progresses to paralysis

This MRI show a tumor completely compressing the spinal canal of the thoracic spine. One would notice the complete obliteration of the image of the spinal cord. This has already resulted in complete paralysis of the patient. Immediate attention should be sought when malignancy of the spine is a consideration.