Primary and metastatic spinal tumors

Primary and metastatic spinal tumors. 

Primary tumors can be benign and malignant. Any of the tumors, by destroying the vertebral body, can reduce its strength and, ultimately, lead to a pathological fracture with the development of severe neurological disorders. Metastatic skeletal tumors occur 2-4 times more often than primary ones and are the third most common cause of metastasis after the lungs and liver (3.9). The ratio between benign, malignant and metastatic lesions of the spine is as follows:

• Primary benign tumors - 1%
• Primary malignant tumors - 3%
• Metastatic tumors - 96%

The most common benign tumor of the spine is hemangioma, and among secondary malignant tumors are metastatic tumors and myeloma.

Metastatic lesions of the spine are the result of tumor cells being carried into the spine from other organs by blood or lymph. Most often, the primary source of metastases to the spine are tumors of the lungs, mammary gland, kidneys, prostate gland, but there may be tumors of other organs as well. In 40% of patients with malignant neoplasms, secondary lesions of the spine are detected. And in 20% of cases, it is the lesion of the spine that is the first manifestation of any oncological disease. Metastatic foci are most often localized in the vertebral bodies, and only in 15% of cases do they spread beyond it and into the spinal canal.

Symptoms

The development of spinal cord tumors is accompanied by pain in the spine, which occurs due to compression of the nerve roots. The nature of the pain can be different, reminiscent of pain in myositis, radiculitis, neuralgia, so patients often seek medical help from neurologists without a preliminary X-ray of the spine. With further development of tumors, various parts of the body become numb, but in some cases their sensitivity may increase. Muscle cramps and paralysis appear. If the tumor forms in the lumbar spine, urination and sexual function are impaired.

Metastatic lesions of the spine do not have specific clinical symptoms, and neurological manifestations do not differ from symptoms in other pathological conditions of the spine and spinal cord, therefore, if bone pain occurs in patients with a known primary tumor, the presence of metastatic skeletal lesions can be assumed with a high degree of probability.