Surgical management of spinal mesenchymal tumors

Primary and metastatic spinal mesenchymal tumors are uncommon lesions. Surgical management of these tumors remains a challenge. En bloc wide resection provides the best chance for local tumor control and long-term survival. However, limitations to this technique include technical considerations (including neurovascular anatomy), patient selection, and tumor histology. Intralesional resection provides good neurologic outcomes, but local recurrence rates are high. Postoperative adjuvant chemotherapy with or without radiation may help to delay recurrence and improve outcomes. We present three cases of our surgical experience with spinal mesenchymal tumors for illustrative purposes.