SlideShare uma empresa Scribd logo
1 de 30
Baixar para ler offline
 
Spinal tumors Tumors of the spine are easily classified as extradural, intradural/extramedullary, and intramedullary. Regarding spinal tumors in general, extradural lesions occur most commonly and most are metastatic. Of the intradural lesions (which are rare), 84% are extramedullary, the majority being nerve sheath tumors or meningiomas. Approximately 16% of intradural tumors are intramedullary, the most common being ependymoma followed by astrocytoma. A  primary  spinal tumor means it comes from cells within or near the spine. They can involve the spinal cord, nerve roots, and/or the vertebrae (bones of the spine) and pelvis. They can be  benign  (non-cancerous) or  malignant  (cancerous). In general, benign tumors do not invade other tissues. Malignant tumors may invade other tissues and organs in the body. Although primary spinal tumors often contain a number of abnormal genes their cause remains unknown. In some cases the tumors run in families.  Tumors in the spine become a problem when they compress the spinal cord or nerves. This can lead to serious complications such as paralysis and loss of bladder and bowel control. Others can destroy the vertebral bone that supports the spinal cord making it unstable.  A  secondary  spinal tumor is more common. This means that the tumor traveled there from cancer somewhere else in the body. These secondary or  metastasized  tumors are always cancerous. These cancer cells travel and cause tumors that usually involve the  vertebrae  or bony portion of the spine. They may come from  melanoma  (skin cancer), cancer in the lung, breast, prostate, kidney, or thyroid gland for example  
Spinal tumors
[object Object],[object Object],[object Object],[object Object],Spinal tumors-epidemiology
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Spinal tumors
Surgery Complete surgical removal is the treatment of choice for most spinal tumors.  This can be accomplished in almost all cases by means of a standard posterior laminectomy.  A laminectomy is the removal of the back part of the bony spine to gain access to the spinal canal.  Decompression refers to removing bone around the spinal cord or spinal nerves in order to take pressure off these structures. Neurological damage during surgery has been improved with the use of newer techniques. These techniques include ultrasonic aspirators, and microsurgery. Ultrasonic aspirators use sound waves to destroy the tumor. It also sucks up the pieces of tumor. Microsurgery uses a microscope for a better view of the operation site. This helps to minimize any damage to surrounding healthy tissue. If the spine needs to be stabilized or fused as a result of removing a tumor in bone, metal hardware may be required. Metal plates, cages, rods, or screws may be used. The bone may be additionally supported by bone graft or bone cement.  Recurrences are rare if total removal has been achieved. Some tumors may not be possible for complete excision and radiotherapy may be necessary.  Radio- and Chemo-therapy Malignant tumors may require additional treatment with radiation or chemotherapy.  Referrals will be made to the oncologist and therapeutic radiologist for evaluation based on histology results after surgery. Spinal tumors-Treatment
 
Malignant spinal tumors-Osteosarcoma  Osteosarcoma  occurs most often in children, adolescents, and young adults. Males are more likely to be affected than females. Treatment usually consists of removal of the tumor when possible as well as chemotherapy. Radiation therapy is not effective. Older persons with Paget's disease or who have had radiation therapy may develop this type of tumor.   
Malignant spinal-Chondrosarcoma Chondrosarcoma  usually occurs in adults. They usually are noticed because they cause pain and swelling. Surgery is performed to remove the tumor and any tumors that have spread, usually to the lung. In most cases, chemotherapy is not effective.  
Malignant spinal-Astrocytomas  Astrocytomas  are tumors that involve nerve cells within the spinal cord. They most commonly occur in children and adolescents. Neurological symptoms such as weakness and/or sensory changes may be the cause for seeking treatment. They tend to spread throughout the spinal cord and brain. Astrocytomas in the spine can usually be removed surgically. However, they are difficult to completely remove. Radiation therapy may be necessary following surgery to slow the spread of the tumor.  Spinal cord astrocytoma
Multiple Myeloma Myeloma is the most common primary malignant tumor of bone. It typically affects adults greater than 40 years of age. It tends to be generalized, involving multiple bones, but back pain and involvement of the spine is the most common presenting complaint. Treatment is palliative; meaning that disease can be controlled, but not completely cured. Chemotherapy is used to control the pain and slow the progression of the disease. Surgery may be required if pathological fractures develop or there is compression of the spinal cord. Cancer in the bone marrow is called multiple myeloma. Bone tissue is destroyed by excessive growth of plasma cells in the bone marrow. When X-rayed it appears that holes have been taken out of the bone. These are called osteolytic lesions. Plasma cells are part of the immune system and in multiple myeloma they grow uncontrolled forming tumors in the bone marrow. The spine is the most common site of involvement with multiple myeloma. Extradural compressive lesions are a well known complication of this disease.  Sagittal 3-dimensional CT reconstruction of the lumbar spine in a patient with multiple myeloma. The central portions of the vertebral bodies (yellow arrows) have been replaced by the nonossified tumor.   Malignant spinal-Multiple Myeloma
Malignant spinal-Multiple Myeloma
Spinal involvement is not uncommon with lymphoma. This can arise secondarily from extension of disease involving paravertebral lymph nodes into the vertebral body or through foramina into the epidural space. The tumor may also primarily infiltrate the vertebral body or epidural space. Primary spinal cord lymphoma is rare.   L1 vertebral mass biopsy showing diffuse sclerotic large B-cell lymphoma.  Malignant spinal-Lymphoma
 
Benign Spinal tumors-osteoma Osteoid osteoma  is the most common of the benign tumors involving the bone of the spine. It is usually found during adolescence. It may be discovered because of scoliosis or curvature of the spine. It may cause pain that does not ease up, and is worse at night. Anti-inflammatory medications are used for treatment. Sometimes removal of the tumor by surgery is necessary. A newer, less invasive treatment is called  radio-frequency ablation . These tumors rarely recur.     
Osteoblastomas  are larger versions of osteoid osteomas. They tend to be found in people under the age of 30. They may cause scoliosis or curvature of the spine. Osteoblastomas tend to be more aggressive and require surgery to remove the tumor. There is a 10% chance that the tumor may recur.    MRI T1  Osteoblastoma Benign Spinal tumors-Osteoblastomas
Enchondromas  are tumors involving cartilage. They may grow into the spinal canal or press on the spinal nerve roots. When they cause paralysis, bowel or bladder incontinence, or other neurological symptoms they are surgically removed. They rarely can become chondrosarcomas, which are malignant tumors that can spread to other parts of the body.  Osteochondroma  is a slow growing tumor of the cartilage usually affecting adolescents. It is uncommon and is usually found in the posterior (rear) spine.  Benign Spinal tumors-Enchondromas&Osteochondroma  Osteochondroma
Giant cell tumors  are very rare. 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. They to affect the vertebral body of a spinal segment.  Benign Spinal tumors-Giant cell tumors  Giant cell tumor
Aneurysmal Bone Cysts (ABCs)  typically cause pain and swelling usually affecting children and adolescents. These tumors can be large and quite vascular.  Benign Spinal tumors-Aneurysmal Bone Cysts
Schwannomas are encapsulated, solitary tumors that derive from Schwann cells . They arise adjacent to, and displace the involved nerve root. Schwannomas and neurofibromas typically involve the dorsal sensory nerve roots. Depending upon their site of origin, they can be intradural, extradural, or both, forming a “dumbbell” or hour-glass shaped mass.    MRI T1 ,precontrast [left, middle] and postcontrast [right] showing a spinal schwannoma, notice the T1 hypointensity and the dense contrast enhancement  Benign Spinal tumors-Schwannomas
Benign Spinal tumors-Schwannomas
Meningioma  is the most common spinal cord tumor.  Spinal meningiomas predominate after the fourth decade and show a striking female predominance. They arise from meningothelial cells that are clustered around the spinal nerve roots .     Dural based mass lesion in upper thoracic spine with same signal intensity as that of spinal cord with displacment of cord to the right.Homogenous enhancement with contrast. Benign Spinal tumors-Spinal meningioma
A and B: Sagittal T1-weighted MR images of the thoracic spine before (A) and after (B) Gd administration demonstrating an intradural extramedullary, isointense meningioma at T-2 that homogenously enhances. C: Axial image revealing that the mass severely compresses and displaces the spinal cord (arrowhead) to the left. Benign Spinal tumors-Spinal meningioma
Ependymoma is a tumor involving the cells lining the canal in the center of the spinal cord. It is important to attempt to distinguish an ependymoma from an astrocytoma preoperatively as the neurosurgeon will attempt complete extirpation of ependymoma, whereas the infiltrative astrocytoma will not be completely resectable.   Spinal cord ependymoma  Benign Spinal tumors-Ependymoma
Hemangiomas are tumors involving blood vessels that affect the vertebral body of a spinal segment. They are most commonly found in the thoracic or lumbar portion of the spine. They occur more frequently during mid-life. They are found more often in women than men. They can be a source of pain but often do not cause pain. They may be large enough to cause collapse of the vertebral body which could affect the spinal cord or nerve roots.      Vertebral haemangioma Benign Spinal tumors-Hemangioma
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 and paraparesis. On occasion, they may heal spontaneously.   Eosinophilic Granuloma  Benign Spinal tumors-Eosinophilic Granuloma
Chordoma  is usually seen in adults frequently (50%) involving the sacrum, although it can affect other parts of the spine such as the occipito-cervical junction (where the head joins the neck). Because they can aggressively grow, they can cause compression of the spinal cord or nerve roots causing neurological problems. These tumors often require aggressive medical therapy.   Benign Spinal tumors-Chordoma
Plasmacytoma  is a single tumor involving the bone of a spinal segment. These tumors are common in the pedicle and vertebral body and may cause paraparesis. It can have characteristic punched out holes in the bone on X-ray. It can cause a compression fracture of the vertebral body. This can cause neurological symptoms. Plasmacytoma presents in middle aged and older adults.    Benign Spinal tumors-Chordoma
Benign Spinal tumors-Chordoma  Plasmacytoma X-ray
Acknowledgements That’s all folks!

Mais conteúdo relacionado

Mais procurados

Craniovertebral JUNCTION ANOMALIES
Craniovertebral JUNCTION ANOMALIESCraniovertebral JUNCTION ANOMALIES
Craniovertebral JUNCTION ANOMALIESUphar Gupta
 
Spinal cord tumors
Spinal cord tumorsSpinal cord tumors
Spinal cord tumorsANILKUMAR BR
 
Malignant bone tumours
Malignant bone tumoursMalignant bone tumours
Malignant bone tumoursArchana Koshy
 
Spinal Epidural Abscess
Spinal Epidural Abscess Spinal Epidural Abscess
Spinal Epidural Abscess Ade Wijaya
 
Spinal dysraphism
Spinal dysraphismSpinal dysraphism
Spinal dysraphismairwave12
 
Congenital Anomalies Of Spine And Spinal Cord
Congenital Anomalies Of Spine And Spinal CordCongenital Anomalies Of Spine And Spinal Cord
Congenital Anomalies Of Spine And Spinal CordRoshan Valentine
 
Presentation1.pptx, radiological imaging of benign bone tumour.
Presentation1.pptx, radiological imaging of benign bone tumour.Presentation1.pptx, radiological imaging of benign bone tumour.
Presentation1.pptx, radiological imaging of benign bone tumour.Abdellah Nazeer
 
Cranio vertebral junction anomalies
Cranio vertebral  junction anomaliesCranio vertebral  junction anomalies
Cranio vertebral junction anomaliesNeurologyKota
 
Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)
Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)
Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)College of Medicine, Sulaymaniyah
 
Presentation1, radiological imaging of degenerative and inflammatory disease ...
Presentation1, radiological imaging of degenerative and inflammatory disease ...Presentation1, radiological imaging of degenerative and inflammatory disease ...
Presentation1, radiological imaging of degenerative and inflammatory disease ...Abdellah Nazeer
 
Benign bone tumours
Benign bone tumoursBenign bone tumours
Benign bone tumoursArif S
 
Benign bone tumors
Benign bone tumorsBenign bone tumors
Benign bone tumorsmacshrestha
 

Mais procurados (20)

Spinal tumors
Spinal tumorsSpinal tumors
Spinal tumors
 
Spinal tumor
Spinal tumorSpinal tumor
Spinal tumor
 
Cvj anomalies
Cvj anomaliesCvj anomalies
Cvj anomalies
 
Craniovertebral JUNCTION ANOMALIES
Craniovertebral JUNCTION ANOMALIESCraniovertebral JUNCTION ANOMALIES
Craniovertebral JUNCTION ANOMALIES
 
Spinal tumors
Spinal tumorsSpinal tumors
Spinal tumors
 
Spinal cord tumors
Spinal cord tumorsSpinal cord tumors
Spinal cord tumors
 
Malignant bone tumours
Malignant bone tumoursMalignant bone tumours
Malignant bone tumours
 
Conus medullaris
Conus medullarisConus medullaris
Conus medullaris
 
Brain spinal tumors
Brain spinal tumorsBrain spinal tumors
Brain spinal tumors
 
Dr.mumtaz ali
Dr.mumtaz aliDr.mumtaz ali
Dr.mumtaz ali
 
Spinal Epidural Abscess
Spinal Epidural Abscess Spinal Epidural Abscess
Spinal Epidural Abscess
 
Spinal dysraphism
Spinal dysraphismSpinal dysraphism
Spinal dysraphism
 
Congenital Anomalies Of Spine And Spinal Cord
Congenital Anomalies Of Spine And Spinal CordCongenital Anomalies Of Spine And Spinal Cord
Congenital Anomalies Of Spine And Spinal Cord
 
Presentation1.pptx, radiological imaging of benign bone tumour.
Presentation1.pptx, radiological imaging of benign bone tumour.Presentation1.pptx, radiological imaging of benign bone tumour.
Presentation1.pptx, radiological imaging of benign bone tumour.
 
Cranio vertebral junction anomalies
Cranio vertebral  junction anomaliesCranio vertebral  junction anomalies
Cranio vertebral junction anomalies
 
Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)
Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)
Surgery 5th year, 1st lecture/part one (Dr. Khalid Shokor Mahmood)
 
Presentation1, radiological imaging of degenerative and inflammatory disease ...
Presentation1, radiological imaging of degenerative and inflammatory disease ...Presentation1, radiological imaging of degenerative and inflammatory disease ...
Presentation1, radiological imaging of degenerative and inflammatory disease ...
 
Potts spine
Potts spinePotts spine
Potts spine
 
Benign bone tumours
Benign bone tumoursBenign bone tumours
Benign bone tumours
 
Benign bone tumors
Benign bone tumorsBenign bone tumors
Benign bone tumors
 

Semelhante a Spinal tumors lecture

Oncologic conditions of brain and spinal cord
Oncologic conditions of brain and spinal cordOncologic conditions of brain and spinal cord
Oncologic conditions of brain and spinal cordBobby Abraham
 
bonetumor-180626174308.pdf
bonetumor-180626174308.pdfbonetumor-180626174308.pdf
bonetumor-180626174308.pdfMISSCOM1
 
BONE TUMORS.ppt
BONE TUMORS.pptBONE TUMORS.ppt
BONE TUMORS.pptHOME
 
Primary bone tumors
Primary bone tumorsPrimary bone tumors
Primary bone tumorsDpt Memon
 
BONE FRACTURES AND DISORDERS GROUP.pptx
BONE FRACTURES AND DISORDERS  GROUP.pptxBONE FRACTURES AND DISORDERS  GROUP.pptx
BONE FRACTURES AND DISORDERS GROUP.pptxBilisumaTAyana
 
Bone cancer
Bone cancerBone cancer
Bone cancerxiran
 
I LOVE NEUROSURGERY INITIATIVE: Spinal Tumors
I LOVE NEUROSURGERY INITIATIVE: Spinal TumorsI LOVE NEUROSURGERY INITIATIVE: Spinal Tumors
I LOVE NEUROSURGERY INITIATIVE: Spinal Tumorswalid maani
 
Common benign and malignant bone tumors
Common benign and malignant bone tumorsCommon benign and malignant bone tumors
Common benign and malignant bone tumorsahm732
 
Primary vertebral body...........
Primary vertebral body...........Primary vertebral body...........
Primary vertebral body...........Yashveer Singh
 
Spinal cord lesions and its radiological imaging finding.
Spinal cord lesions and its radiological imaging finding.Spinal cord lesions and its radiological imaging finding.
Spinal cord lesions and its radiological imaging finding.Navneet Ranjan
 
Metastatic bone disease
Metastatic bone diseaseMetastatic bone disease
Metastatic bone diseaseSaurabh Chahar
 
spinaltumors-copy-160925185617 (1).pptx
spinaltumors-copy-160925185617 (1).pptxspinaltumors-copy-160925185617 (1).pptx
spinaltumors-copy-160925185617 (1).pptxChintanBanugariya1
 
bone tumors 2.ppt
bone tumors 2.pptbone tumors 2.ppt
bone tumors 2.pptdrqazi7777
 
Cancer is Curable if Detected Early
Cancer is Curable if Detected EarlyCancer is Curable if Detected Early
Cancer is Curable if Detected EarlyBipin Parab
 
metastatic-bone-tumor.ppt
metastatic-bone-tumor.pptmetastatic-bone-tumor.ppt
metastatic-bone-tumor.pptN3LUMBO
 

Semelhante a Spinal tumors lecture (20)

Oncologic conditions of brain and spinal cord
Oncologic conditions of brain and spinal cordOncologic conditions of brain and spinal cord
Oncologic conditions of brain and spinal cord
 
Bone tumor
Bone tumorBone tumor
Bone tumor
 
bonetumor-180626174308.pdf
bonetumor-180626174308.pdfbonetumor-180626174308.pdf
bonetumor-180626174308.pdf
 
BONE TUMORS.ppt
BONE TUMORS.pptBONE TUMORS.ppt
BONE TUMORS.ppt
 
Primary bone tumors
Primary bone tumorsPrimary bone tumors
Primary bone tumors
 
BONE FRACTURES AND DISORDERS GROUP.pptx
BONE FRACTURES AND DISORDERS  GROUP.pptxBONE FRACTURES AND DISORDERS  GROUP.pptx
BONE FRACTURES AND DISORDERS GROUP.pptx
 
Bone cancer
Bone cancerBone cancer
Bone cancer
 
I LOVE NEUROSURGERY INITIATIVE: Spinal Tumors
I LOVE NEUROSURGERY INITIATIVE: Spinal TumorsI LOVE NEUROSURGERY INITIATIVE: Spinal Tumors
I LOVE NEUROSURGERY INITIATIVE: Spinal Tumors
 
Bone tumors
Bone tumorsBone tumors
Bone tumors
 
Common benign and malignant bone tumors
Common benign and malignant bone tumorsCommon benign and malignant bone tumors
Common benign and malignant bone tumors
 
Osteosarcoma
OsteosarcomaOsteosarcoma
Osteosarcoma
 
Primary vertebral body...........
Primary vertebral body...........Primary vertebral body...........
Primary vertebral body...........
 
Spinal cord lesions and its radiological imaging finding.
Spinal cord lesions and its radiological imaging finding.Spinal cord lesions and its radiological imaging finding.
Spinal cord lesions and its radiological imaging finding.
 
Metastatic bone disease
Metastatic bone diseaseMetastatic bone disease
Metastatic bone disease
 
spinaltumors-copy-160925185617 (1).pptx
spinaltumors-copy-160925185617 (1).pptxspinaltumors-copy-160925185617 (1).pptx
spinaltumors-copy-160925185617 (1).pptx
 
Bone Tumors Benign Ppt
Bone Tumors Benign PptBone Tumors Benign Ppt
Bone Tumors Benign Ppt
 
Malignant Tumors of bones
Malignant Tumors of bones Malignant Tumors of bones
Malignant Tumors of bones
 
bone tumors 2.ppt
bone tumors 2.pptbone tumors 2.ppt
bone tumors 2.ppt
 
Cancer is Curable if Detected Early
Cancer is Curable if Detected EarlyCancer is Curable if Detected Early
Cancer is Curable if Detected Early
 
metastatic-bone-tumor.ppt
metastatic-bone-tumor.pptmetastatic-bone-tumor.ppt
metastatic-bone-tumor.ppt
 

Mais de test

Recombinant protein expression and purification Lecture
Recombinant protein expression and purification LectureRecombinant protein expression and purification Lecture
Recombinant protein expression and purification Lecturetest
 
Stem cell & therapeutic cloning Lecture
Stem cell & therapeutic cloning LectureStem cell & therapeutic cloning Lecture
Stem cell & therapeutic cloning Lecturetest
 
Short presentation version cns infections Lecture
Short presentation version cns infections LectureShort presentation version cns infections Lecture
Short presentation version cns infections Lecturetest
 
Cns infections Lecture
Cns infections LectureCns infections Lecture
Cns infections Lecturetest
 
Headaches Lecture
Headaches LectureHeadaches Lecture
Headaches Lecturetest
 
Traumatic brain injury
Traumatic brain injuryTraumatic brain injury
Traumatic brain injurytest
 
Neuroimaging Lecture
Neuroimaging LectureNeuroimaging Lecture
Neuroimaging Lecturetest
 
Movement disorders lecture
Movement disorders lectureMovement disorders lecture
Movement disorders lecturetest
 
Parkinsons Disease
Parkinsons DiseaseParkinsons Disease
Parkinsons Diseasetest
 
Cns tumors
Cns tumorsCns tumors
Cns tumorstest
 

Mais de test (10)

Recombinant protein expression and purification Lecture
Recombinant protein expression and purification LectureRecombinant protein expression and purification Lecture
Recombinant protein expression and purification Lecture
 
Stem cell & therapeutic cloning Lecture
Stem cell & therapeutic cloning LectureStem cell & therapeutic cloning Lecture
Stem cell & therapeutic cloning Lecture
 
Short presentation version cns infections Lecture
Short presentation version cns infections LectureShort presentation version cns infections Lecture
Short presentation version cns infections Lecture
 
Cns infections Lecture
Cns infections LectureCns infections Lecture
Cns infections Lecture
 
Headaches Lecture
Headaches LectureHeadaches Lecture
Headaches Lecture
 
Traumatic brain injury
Traumatic brain injuryTraumatic brain injury
Traumatic brain injury
 
Neuroimaging Lecture
Neuroimaging LectureNeuroimaging Lecture
Neuroimaging Lecture
 
Movement disorders lecture
Movement disorders lectureMovement disorders lecture
Movement disorders lecture
 
Parkinsons Disease
Parkinsons DiseaseParkinsons Disease
Parkinsons Disease
 
Cns tumors
Cns tumorsCns tumors
Cns tumors
 

Último

How to Make a Field read-only in Odoo 17
How to Make a Field read-only in Odoo 17How to Make a Field read-only in Odoo 17
How to Make a Field read-only in Odoo 17Celine George
 
Riddhi Kevadiya. WILLIAM SHAKESPEARE....
Riddhi Kevadiya. WILLIAM SHAKESPEARE....Riddhi Kevadiya. WILLIAM SHAKESPEARE....
Riddhi Kevadiya. WILLIAM SHAKESPEARE....Riddhi Kevadiya
 
Slides CapTechTalks Webinar March 2024 Joshua Sinai.pptx
Slides CapTechTalks Webinar March 2024 Joshua Sinai.pptxSlides CapTechTalks Webinar March 2024 Joshua Sinai.pptx
Slides CapTechTalks Webinar March 2024 Joshua Sinai.pptxCapitolTechU
 
3.21.24 The Origins of Black Power.pptx
3.21.24  The Origins of Black Power.pptx3.21.24  The Origins of Black Power.pptx
3.21.24 The Origins of Black Power.pptxmary850239
 
Ultra structure and life cycle of Plasmodium.pptx
Ultra structure and life cycle of Plasmodium.pptxUltra structure and life cycle of Plasmodium.pptx
Ultra structure and life cycle of Plasmodium.pptxDr. Asif Anas
 
The basics of sentences session 10pptx.pptx
The basics of sentences session 10pptx.pptxThe basics of sentences session 10pptx.pptx
The basics of sentences session 10pptx.pptxheathfieldcps1
 
Work Experience for psp3 portfolio sasha
Work Experience for psp3 portfolio sashaWork Experience for psp3 portfolio sasha
Work Experience for psp3 portfolio sashasashalaycock03
 
KARNAADA.pptx made by - saransh dwivedi ( SD ) - SHALAKYA TANTRA - ENT - 4...
KARNAADA.pptx  made by -  saransh dwivedi ( SD ) -  SHALAKYA TANTRA - ENT - 4...KARNAADA.pptx  made by -  saransh dwivedi ( SD ) -  SHALAKYA TANTRA - ENT - 4...
KARNAADA.pptx made by - saransh dwivedi ( SD ) - SHALAKYA TANTRA - ENT - 4...M56BOOKSTORE PRODUCT/SERVICE
 
Easter in the USA presentation by Chloe.
Easter in the USA presentation by Chloe.Easter in the USA presentation by Chloe.
Easter in the USA presentation by Chloe.EnglishCEIPdeSigeiro
 
Quality Assurance_GOOD LABORATORY PRACTICE
Quality Assurance_GOOD LABORATORY PRACTICEQuality Assurance_GOOD LABORATORY PRACTICE
Quality Assurance_GOOD LABORATORY PRACTICESayali Powar
 
Protein Structure - threading Protein modelling pptx
Protein Structure - threading Protein modelling pptxProtein Structure - threading Protein modelling pptx
Protein Structure - threading Protein modelling pptxvidhisharma994099
 
SOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptx
SOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptxSOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptx
SOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptxSyedNadeemGillANi
 
Prescribed medication order and communication skills.pptx
Prescribed medication order and communication skills.pptxPrescribed medication order and communication skills.pptx
Prescribed medication order and communication skills.pptxraviapr7
 
A gentle introduction to Artificial Intelligence
A gentle introduction to Artificial IntelligenceA gentle introduction to Artificial Intelligence
A gentle introduction to Artificial IntelligenceApostolos Syropoulos
 
10 Topics For MBA Project Report [HR].pdf
10 Topics For MBA Project Report [HR].pdf10 Topics For MBA Project Report [HR].pdf
10 Topics For MBA Project Report [HR].pdfJayanti Pande
 
CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...
CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...
CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...Nguyen Thanh Tu Collection
 
The Stolen Bacillus by Herbert George Wells
The Stolen Bacillus by Herbert George WellsThe Stolen Bacillus by Herbert George Wells
The Stolen Bacillus by Herbert George WellsEugene Lysak
 
Diploma in Nursing Admission Test Question Solution 2023.pdf
Diploma in Nursing Admission Test Question Solution 2023.pdfDiploma in Nursing Admission Test Question Solution 2023.pdf
Diploma in Nursing Admission Test Question Solution 2023.pdfMohonDas
 

Último (20)

How to Make a Field read-only in Odoo 17
How to Make a Field read-only in Odoo 17How to Make a Field read-only in Odoo 17
How to Make a Field read-only in Odoo 17
 
Prelims of Kant get Marx 2.0: a general politics quiz
Prelims of Kant get Marx 2.0: a general politics quizPrelims of Kant get Marx 2.0: a general politics quiz
Prelims of Kant get Marx 2.0: a general politics quiz
 
Riddhi Kevadiya. WILLIAM SHAKESPEARE....
Riddhi Kevadiya. WILLIAM SHAKESPEARE....Riddhi Kevadiya. WILLIAM SHAKESPEARE....
Riddhi Kevadiya. WILLIAM SHAKESPEARE....
 
Slides CapTechTalks Webinar March 2024 Joshua Sinai.pptx
Slides CapTechTalks Webinar March 2024 Joshua Sinai.pptxSlides CapTechTalks Webinar March 2024 Joshua Sinai.pptx
Slides CapTechTalks Webinar March 2024 Joshua Sinai.pptx
 
3.21.24 The Origins of Black Power.pptx
3.21.24  The Origins of Black Power.pptx3.21.24  The Origins of Black Power.pptx
3.21.24 The Origins of Black Power.pptx
 
Ultra structure and life cycle of Plasmodium.pptx
Ultra structure and life cycle of Plasmodium.pptxUltra structure and life cycle of Plasmodium.pptx
Ultra structure and life cycle of Plasmodium.pptx
 
The basics of sentences session 10pptx.pptx
The basics of sentences session 10pptx.pptxThe basics of sentences session 10pptx.pptx
The basics of sentences session 10pptx.pptx
 
Work Experience for psp3 portfolio sasha
Work Experience for psp3 portfolio sashaWork Experience for psp3 portfolio sasha
Work Experience for psp3 portfolio sasha
 
KARNAADA.pptx made by - saransh dwivedi ( SD ) - SHALAKYA TANTRA - ENT - 4...
KARNAADA.pptx  made by -  saransh dwivedi ( SD ) -  SHALAKYA TANTRA - ENT - 4...KARNAADA.pptx  made by -  saransh dwivedi ( SD ) -  SHALAKYA TANTRA - ENT - 4...
KARNAADA.pptx made by - saransh dwivedi ( SD ) - SHALAKYA TANTRA - ENT - 4...
 
Easter in the USA presentation by Chloe.
Easter in the USA presentation by Chloe.Easter in the USA presentation by Chloe.
Easter in the USA presentation by Chloe.
 
Quality Assurance_GOOD LABORATORY PRACTICE
Quality Assurance_GOOD LABORATORY PRACTICEQuality Assurance_GOOD LABORATORY PRACTICE
Quality Assurance_GOOD LABORATORY PRACTICE
 
Personal Resilience in Project Management 2 - TV Edit 1a.pdf
Personal Resilience in Project Management 2 - TV Edit 1a.pdfPersonal Resilience in Project Management 2 - TV Edit 1a.pdf
Personal Resilience in Project Management 2 - TV Edit 1a.pdf
 
Protein Structure - threading Protein modelling pptx
Protein Structure - threading Protein modelling pptxProtein Structure - threading Protein modelling pptx
Protein Structure - threading Protein modelling pptx
 
SOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptx
SOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptxSOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptx
SOLIDE WASTE in Cameroon,,,,,,,,,,,,,,,,,,,,,,,,,,,.pptx
 
Prescribed medication order and communication skills.pptx
Prescribed medication order and communication skills.pptxPrescribed medication order and communication skills.pptx
Prescribed medication order and communication skills.pptx
 
A gentle introduction to Artificial Intelligence
A gentle introduction to Artificial IntelligenceA gentle introduction to Artificial Intelligence
A gentle introduction to Artificial Intelligence
 
10 Topics For MBA Project Report [HR].pdf
10 Topics For MBA Project Report [HR].pdf10 Topics For MBA Project Report [HR].pdf
10 Topics For MBA Project Report [HR].pdf
 
CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...
CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...
CHUYÊN ĐỀ DẠY THÊM TIẾNG ANH LỚP 11 - GLOBAL SUCCESS - NĂM HỌC 2023-2024 - HK...
 
The Stolen Bacillus by Herbert George Wells
The Stolen Bacillus by Herbert George WellsThe Stolen Bacillus by Herbert George Wells
The Stolen Bacillus by Herbert George Wells
 
Diploma in Nursing Admission Test Question Solution 2023.pdf
Diploma in Nursing Admission Test Question Solution 2023.pdfDiploma in Nursing Admission Test Question Solution 2023.pdf
Diploma in Nursing Admission Test Question Solution 2023.pdf
 

Spinal tumors lecture

  • 1.  
  • 2. Spinal tumors Tumors of the spine are easily classified as extradural, intradural/extramedullary, and intramedullary. Regarding spinal tumors in general, extradural lesions occur most commonly and most are metastatic. Of the intradural lesions (which are rare), 84% are extramedullary, the majority being nerve sheath tumors or meningiomas. Approximately 16% of intradural tumors are intramedullary, the most common being ependymoma followed by astrocytoma. A primary spinal tumor means it comes from cells within or near the spine. They can involve the spinal cord, nerve roots, and/or the vertebrae (bones of the spine) and pelvis. They can be benign (non-cancerous) or malignant (cancerous). In general, benign tumors do not invade other tissues. Malignant tumors may invade other tissues and organs in the body. Although primary spinal tumors often contain a number of abnormal genes their cause remains unknown. In some cases the tumors run in families. Tumors in the spine become a problem when they compress the spinal cord or nerves. This can lead to serious complications such as paralysis and loss of bladder and bowel control. Others can destroy the vertebral bone that supports the spinal cord making it unstable. A secondary spinal tumor is more common. This means that the tumor traveled there from cancer somewhere else in the body. These secondary or metastasized tumors are always cancerous. These cancer cells travel and cause tumors that usually involve the vertebrae or bony portion of the spine. They may come from melanoma (skin cancer), cancer in the lung, breast, prostate, kidney, or thyroid gland for example  
  • 4.
  • 5.
  • 6. Surgery Complete surgical removal is the treatment of choice for most spinal tumors. This can be accomplished in almost all cases by means of a standard posterior laminectomy. A laminectomy is the removal of the back part of the bony spine to gain access to the spinal canal. Decompression refers to removing bone around the spinal cord or spinal nerves in order to take pressure off these structures. Neurological damage during surgery has been improved with the use of newer techniques. These techniques include ultrasonic aspirators, and microsurgery. Ultrasonic aspirators use sound waves to destroy the tumor. It also sucks up the pieces of tumor. Microsurgery uses a microscope for a better view of the operation site. This helps to minimize any damage to surrounding healthy tissue. If the spine needs to be stabilized or fused as a result of removing a tumor in bone, metal hardware may be required. Metal plates, cages, rods, or screws may be used. The bone may be additionally supported by bone graft or bone cement. Recurrences are rare if total removal has been achieved. Some tumors may not be possible for complete excision and radiotherapy may be necessary. Radio- and Chemo-therapy Malignant tumors may require additional treatment with radiation or chemotherapy. Referrals will be made to the oncologist and therapeutic radiologist for evaluation based on histology results after surgery. Spinal tumors-Treatment
  • 7.  
  • 8. Malignant spinal tumors-Osteosarcoma Osteosarcoma occurs most often in children, adolescents, and young adults. Males are more likely to be affected than females. Treatment usually consists of removal of the tumor when possible as well as chemotherapy. Radiation therapy is not effective. Older persons with Paget's disease or who have had radiation therapy may develop this type of tumor.  
  • 9. Malignant spinal-Chondrosarcoma Chondrosarcoma usually occurs in adults. They usually are noticed because they cause pain and swelling. Surgery is performed to remove the tumor and any tumors that have spread, usually to the lung. In most cases, chemotherapy is not effective.  
  • 10. Malignant spinal-Astrocytomas Astrocytomas are tumors that involve nerve cells within the spinal cord. They most commonly occur in children and adolescents. Neurological symptoms such as weakness and/or sensory changes may be the cause for seeking treatment. They tend to spread throughout the spinal cord and brain. Astrocytomas in the spine can usually be removed surgically. However, they are difficult to completely remove. Radiation therapy may be necessary following surgery to slow the spread of the tumor. Spinal cord astrocytoma
  • 11. Multiple Myeloma Myeloma is the most common primary malignant tumor of bone. It typically affects adults greater than 40 years of age. It tends to be generalized, involving multiple bones, but back pain and involvement of the spine is the most common presenting complaint. Treatment is palliative; meaning that disease can be controlled, but not completely cured. Chemotherapy is used to control the pain and slow the progression of the disease. Surgery may be required if pathological fractures develop or there is compression of the spinal cord. Cancer in the bone marrow is called multiple myeloma. Bone tissue is destroyed by excessive growth of plasma cells in the bone marrow. When X-rayed it appears that holes have been taken out of the bone. These are called osteolytic lesions. Plasma cells are part of the immune system and in multiple myeloma they grow uncontrolled forming tumors in the bone marrow. The spine is the most common site of involvement with multiple myeloma. Extradural compressive lesions are a well known complication of this disease. Sagittal 3-dimensional CT reconstruction of the lumbar spine in a patient with multiple myeloma. The central portions of the vertebral bodies (yellow arrows) have been replaced by the nonossified tumor.   Malignant spinal-Multiple Myeloma
  • 13. Spinal involvement is not uncommon with lymphoma. This can arise secondarily from extension of disease involving paravertebral lymph nodes into the vertebral body or through foramina into the epidural space. The tumor may also primarily infiltrate the vertebral body or epidural space. Primary spinal cord lymphoma is rare.   L1 vertebral mass biopsy showing diffuse sclerotic large B-cell lymphoma. Malignant spinal-Lymphoma
  • 14.  
  • 15. Benign Spinal tumors-osteoma Osteoid osteoma is the most common of the benign tumors involving the bone of the spine. It is usually found during adolescence. It may be discovered because of scoliosis or curvature of the spine. It may cause pain that does not ease up, and is worse at night. Anti-inflammatory medications are used for treatment. Sometimes removal of the tumor by surgery is necessary. A newer, less invasive treatment is called radio-frequency ablation . These tumors rarely recur.    
  • 16. Osteoblastomas are larger versions of osteoid osteomas. They tend to be found in people under the age of 30. They may cause scoliosis or curvature of the spine. Osteoblastomas tend to be more aggressive and require surgery to remove the tumor. There is a 10% chance that the tumor may recur.   MRI T1 Osteoblastoma Benign Spinal tumors-Osteoblastomas
  • 17. Enchondromas are tumors involving cartilage. They may grow into the spinal canal or press on the spinal nerve roots. When they cause paralysis, bowel or bladder incontinence, or other neurological symptoms they are surgically removed. They rarely can become chondrosarcomas, which are malignant tumors that can spread to other parts of the body. Osteochondroma is a slow growing tumor of the cartilage usually affecting adolescents. It is uncommon and is usually found in the posterior (rear) spine. Benign Spinal tumors-Enchondromas&Osteochondroma Osteochondroma
  • 18. Giant cell tumors are very rare. 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. They to affect the vertebral body of a spinal segment. Benign Spinal tumors-Giant cell tumors Giant cell tumor
  • 19. Aneurysmal Bone Cysts (ABCs) typically cause pain and swelling usually affecting children and adolescents. These tumors can be large and quite vascular. Benign Spinal tumors-Aneurysmal Bone Cysts
  • 20. Schwannomas are encapsulated, solitary tumors that derive from Schwann cells . They arise adjacent to, and displace the involved nerve root. Schwannomas and neurofibromas typically involve the dorsal sensory nerve roots. Depending upon their site of origin, they can be intradural, extradural, or both, forming a “dumbbell” or hour-glass shaped mass.   MRI T1 ,precontrast [left, middle] and postcontrast [right] showing a spinal schwannoma, notice the T1 hypointensity and the dense contrast enhancement Benign Spinal tumors-Schwannomas
  • 22. Meningioma is the most common spinal cord tumor. Spinal meningiomas predominate after the fourth decade and show a striking female predominance. They arise from meningothelial cells that are clustered around the spinal nerve roots .   Dural based mass lesion in upper thoracic spine with same signal intensity as that of spinal cord with displacment of cord to the right.Homogenous enhancement with contrast. Benign Spinal tumors-Spinal meningioma
  • 23. A and B: Sagittal T1-weighted MR images of the thoracic spine before (A) and after (B) Gd administration demonstrating an intradural extramedullary, isointense meningioma at T-2 that homogenously enhances. C: Axial image revealing that the mass severely compresses and displaces the spinal cord (arrowhead) to the left. Benign Spinal tumors-Spinal meningioma
  • 24. Ependymoma is a tumor involving the cells lining the canal in the center of the spinal cord. It is important to attempt to distinguish an ependymoma from an astrocytoma preoperatively as the neurosurgeon will attempt complete extirpation of ependymoma, whereas the infiltrative astrocytoma will not be completely resectable.   Spinal cord ependymoma Benign Spinal tumors-Ependymoma
  • 25. Hemangiomas are tumors involving blood vessels that affect the vertebral body of a spinal segment. They are most commonly found in the thoracic or lumbar portion of the spine. They occur more frequently during mid-life. They are found more often in women than men. They can be a source of pain but often do not cause pain. They may be large enough to cause collapse of the vertebral body which could affect the spinal cord or nerve roots.     Vertebral haemangioma Benign Spinal tumors-Hemangioma
  • 26. 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 and paraparesis. On occasion, they may heal spontaneously.   Eosinophilic Granuloma Benign Spinal tumors-Eosinophilic Granuloma
  • 27. Chordoma is usually seen in adults frequently (50%) involving the sacrum, although it can affect other parts of the spine such as the occipito-cervical junction (where the head joins the neck). Because they can aggressively grow, they can cause compression of the spinal cord or nerve roots causing neurological problems. These tumors often require aggressive medical therapy.   Benign Spinal tumors-Chordoma
  • 28. Plasmacytoma is a single tumor involving the bone of a spinal segment. These tumors are common in the pedicle and vertebral body and may cause paraparesis. It can have characteristic punched out holes in the bone on X-ray. It can cause a compression fracture of the vertebral body. This can cause neurological symptoms. Plasmacytoma presents in middle aged and older adults.   Benign Spinal tumors-Chordoma
  • 29. Benign Spinal tumors-Chordoma Plasmacytoma X-ray