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Neoplastic Myelopathies.

Jing Wu, Surabhi Ranjan

    Continuum (Minneapolis, Minn.)
    |April 4, 2018
    PubMed
    Summary
    This summary is machine-generated.

    Neoplastic myelopathies, including spinal cord tumors and treatment-related disorders, are uncommon but serious. Prompt diagnosis and management of these spinal cord neoplasms are crucial for preventing severe neurological damage.

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    Area of Science:

    • Neurology
    • Oncology
    • Spinal Cord Disorders

    Background:

    • Neoplastic myelopathies are uncommon neurologic disorders causing significant morbidity.
    • Primary spinal cord tumors are classified as intramedullary, intradural extramedullary, or extradural.
    • Metastatic tumors are the most common spinal tumors, and extradural metastatic spinal cord compression is a neurologic emergency.

    Purpose of the Study:

    • To discuss the diagnosis and management of spinal cord neoplasms.
    • To review spinal cord disorders resulting from cancer treatments.
    • To emphasize the importance of early diagnosis and treatment for preventing neurological sequelae.

    Main Methods:

    • Review of primary spinal cord tumor classifications (intramedullary, intradural extramedullary, extradural).
    • Discussion of common intramedullary tumors like diffuse gliomas and ependymal tumors, including their molecular characteristics (e.g., IDH-mutant, 1p/19q codeletion, NF2 mutations).
    • Analysis of metastatic spinal tumors and the emergent nature of extradural metastatic spinal cord compression.

    Main Results:

    • Diffuse gliomas (astrocytomas, oligodendrogliomas, glioblastomas) and ependymomas are common intramedullary tumors with distinct molecular profiles.
    • Ependymomas show nine distinct molecular subgroups, with NF2 mutations frequent in spinal cord ependymomas.
    • Metastatic tumors are the most common spinal neoplasms, and prompt diagnosis of extradural metastatic spinal cord compression is critical for patient outcomes.

    Conclusions:

    • Neoplastic myelopathies encompass a range of conditions, from primary spinal tumors to paraneoplastic syndromes.
    • Understanding the clinical features and management of neoplastic myelopathies is essential for neurologists.
    • Early diagnosis and treatment of spinal cord neoplasms and treatment-related disorders can prevent devastating neurologic sequelae.