Spinal cord tumors represent approximately 15% of central nervous system tumors. Most arise from the substance of the spinal cord itself, the covering of the spinal cord (meninges), or the covering of the nerves (nerve sheaths). Only rarely do these tumors arise from spread (metastasis) of tumors located elsewhere in the body. The majority of spinal cord tumors in adults arise outside of the spinal cord tissue (extramedullary). These are most commonly nerve sheath tumors (schwannomas or neurofibromas), meningiomas and filum terminale ependymomas. One third of spinal cord tumors arise with the cord (intramedullary). Most are either gliomas or ependymomas.
In most cases diagnosis is made when an MRI of the spine is obtained after the patient experiences neurologic symptoms such as weakness or changes in sensation of the arms, legs, or torso. Usually treatment takes the form of surgery to remove the tumor with the goal being to take the pressure off of the spinal cord and nerve roots. These surgeries can be technically challenging and are best treated by a neurosurgeon with experience with these types of lesions. In some cases complete removal is not possible and a biopsy is performed to achieve a diagnosis. Depending on the type of tumor that is present, additional treatment may require radiation therapy or chemotherapy.