A small number of spinal tumors occur in the nerves of the spinal cord itself. Most often these are ependymomas and other gliomas.
Tumors that start in spinal tissue are called primary spinal tumors. Tumors that spread to the spine from some other place (metastasize) are called secondary spinal tumors. Tumors may spread to the spine from the breast, prostate, lung, and other areas.
The cause of primary spinal tumors is unknown. Some primary spinal tumors occur with certain inherited gene mutations.
Spinal tumors can occur:
Inside the spinal cord (intramedullary)
In the membranes (meninges) covering the spinal cord (extramedullary - intradural)
Between the meninges and bones of the spine (extradural)
Or, tumors may extend from other locations. Most spinal tumors are extradural.
As it grows, the tumor can affect the:
Bones of the spine
Spinal cord cells
The tumor may press on the spinal cord or nerve roots, causing damage. With time, the damage may become permanent.
The symptoms depend on the location, type of tumor, and your general health. Tumors that have spread to the spine from another site (metastatic tumors) often progress quickly. Primary tumors often progress slowly over weeks to years.
Tumors in the spinal cord usually cause symptoms, sometimes over large portions of the body. Tumors outside the spinal cord may grow for a long time before causing nerve damage.
Symptoms may include:
Abnormal sensations or loss of sensation, especially in the legs (may be in the knee or ankle, with or without shooting pain down the leg)
Back pain that gets worse over time, is often in the middle or lower back, is usually severe and not relieved by pain medicine, gets worse when lying down or straining (such as during a cough or sneeze), and may extend to the hips or legs
Cold sensation of the legs, cool fingers or hands, or coolness of other areas
The goal of treatment is to reduce or prevent nerve damage caused by pressure on (compression of) the spinal cord.
Treatment should be given quickly. The more quickly symptoms develop, the sooner treatment is needed to prevent permanent injury. Any new or unexplained back pain in a patient with cancer should be thoroughly investigated.
Corticosteroids (dexamethasone) may be given to reduce inflammation and swelling around the spinal cord.
Emergency surgery may be needed to relieve compression on the spinal cord. Some tumors can be completely removed. In other cases, part of the tumor may be removed to relieve pressure on the spinal cord.
Permanent damage to nerves, disability from nerve damage
When to Contact a Medical Professional
Call your health care provider if you have a history of cancer and develop severe back pain that is sudden or gets worse.
Go to the emergency room or call the local emergency number (such as 911) if you develop new symptoms, or your symptoms get worse during the treatment of a spinal tumor.
DeAngelis LM. Tumors of the central nervous system and intracranial hypertension and hypotension. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 195.
Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.