Dysembryogenetic spinal tumours in adults without dysraphism

Area of Science:

• Neurosurgery
• Neurology
• Oncology

Background:

• Dysembryogenetic spinal tumors are rare, often presenting in adulthood without overt signs of dysraphism.
• This series focuses on intradural tumors like lipomas, epidermoid cysts, dermoid cysts, and teratomas.

Purpose of the Study:

• To analyze the clinical presentation, diagnosis, and surgical outcomes of adult-onset spinal intradural dysembryogenetic tumors.
• To differentiate surgical approaches and outcomes based on tumor type and location.

Main Methods:

• Retrospective review of 15 adult patients with spinal intradural dysembryogenetic tumors.
• Analysis of clinical data, magnetic resonance imaging (MRI) findings, surgical procedures, and follow-up outcomes.
• Categorization of tumors by histology (lipoma, epidermoid cyst, dermoid cyst, teratoma) and location (thoracic, lumbar, conus, cauda equina, filum terminale).

Main Results:

• Fifteen patients presented with various intradural tumors; seven lipomas, four epidermoid cysts, three dermoid cysts, and one teratoma.
• Surgical removal was complete in 8/14 patients, subtotal in 2, and partial in 4. Recurrence was observed in one case of epidermoid cyst.
• MRI proved effective for precise diagnosis, particularly for small lipomas and dermoids associated with tethered conus.

Conclusions:

• Spinal dysembryogenetic tumors symptomatic in adulthood warrant surgical intervention.
• Surgical goals include mass reduction and release of tethered neural elements for lipomas, and radical resection for cysts.
• Even partial resections can yield good clinical outcomes with low recurrence risk, prioritizing neural preservation.