Primary Spinal Cord Tumor
Background
At what level does the spinal cord (SC) end in adults? Newborns?
Adults: L1-2
Newborns: L3-4
What is the filum terminale?
The filum terminale is the filamentous process that anchors the dural sack inferiorly to the coccyx.
What is the conus medullaris?
The conus medullaris is the inf/tapering portion of the SC.
What % of all primary CNS malignancies arise in the SC?
~15% of all primary CNS malignancies arise in the SC.
What is the age range for primary SC tumors?
Primary SC tumors occur in the age range of 10–40 yrs.
Are most primary SC tumors intra- or extradural?
Intradural. If extradural, SC tumors are most likely to be metastatic, not primary.
Are most primary SC tumors intra- or extramedullary?
Two thirds of primary SC tumors are extramedullary.
What are the most common and 2nd most common intradural/extramedullary primary SC tumors?
Two thirds are schwannomas, and one third are meningiomas.
What % of primary SC tumors are intramedullary?
10% of primary SC tumors are intramedullary.
What are the most common intramedullary SC tumors, and what age group do they typically affect?
Astrocytomas > ependymomas; children/young adults (<30 yo)
What type of tumor typically arises at the filum terminale?
Myxopapillary ependymomas arise at the filum terminale.
From what anatomic portion of the meninges do mengiomas arise?
Meningiomas arise from the arachnoid layer.
What is a common age range and location for SC meningiomas?
SC meningiomas most often occur at age 50–70 yrs, with most presenting in the thoracic spine.
What grade is most common for primary SC astrocyomas?
~90% are low grade/WHO grades I−II (pilocytic/fibrillary).
What is the 3rd most common intramedullary SC tumor, and with what syndrome can it be associated?
Hemangioblastoma is the 3rd most common intramedullary SC tumor, with ~25% of cases associated with von Hippel-Lindau syndrome.
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