[Spinal intramedullary tumor with exophytic growth]

Area of Science:

• Neurosurgery
• Oncology
• Radiology

Background:

• Spinal intramedullary tumors are rare, and those with exophytic growth present unique clinical and radiological challenges.
• Exophytic growth can alter the typical presentation and diagnostic approach for these tumors.

Purpose of the Study:

• To discuss the clinical and radiological features of spinal intramedullary tumors with exophytic growth.
• To analyze therapeutic challenges and outcomes associated with these specific tumor types.

Main Methods:

• Retrospective review of 22 spinal intramedullary tumor cases, focusing on 5 with exophytic growth.
• Analysis of clinical presentation, neurological examination, and radiological findings (myelography, CT myelography).
• Evaluation of histopathological diagnoses and treatment outcomes, including surgery, radiation, and chemotherapy.

Main Results:

• The conus medullaris was the most common site (60%) for tumors with exophytic growth.
• Initial symptoms commonly included back pain and lumbago, mimicking root pain, with no distinguishing neurological features from extramedullary tumors.
• Myelography and CT myelography were effective in diagnosing extramedullary mass, spinal cord shift, and swelling.

Conclusions:

• Spinal intramedullary tumors with exophytic growth require careful diagnostic evaluation, particularly using advanced imaging techniques.
• While surgical removal, potentially combined with adjuvant therapies, can yield good outcomes, recurrence and intracranial seeding pose significant prognostic risks.
• Postoperative surveillance is essential for early detection of recurrence and intracranial seeding, crucial for improving patient prognosis.