McFaline-Figueroa J Ricardo
Continuum (Minneap Minn). 2024 Feb 1;30(1):99-118. doi: 10.1212/CON.0000000000001375.
This article discusses the diagnostic approach to patients with suspected neoplasms of the spinal cord and reviews the most common primary and metastatic spinal neoplasms and their presentations.
Neoplasms of the spinal cord are rare entities that can involve the spinal cord parenchyma, the dura and leptomeninges, or the extradural space. The most common intramedullary spinal cord neoplasms are primary spinal cord tumors, including ependymomas, pilocytic astrocytomas, and diffuse midline gliomas. The most common primary neoplasms of the spine are intradural extramedullary spinal meningiomas, whereas primary neoplasms of the leptomeninges are rare. Advances in molecular characterization of spinal cord tumors and recent clinical trials of these rare entities are expanding the repertoire of systemic therapy options for primary spinal cord neoplasms. Metastases to the spine most often affect the extradural space. Metastatic epidural spinal cord compression is a neurologic emergency that requires a rapid, multidisciplinary response to preserve neurologic function.
Neurologists should understand the diagnostic approach to neoplasms of the spinal cord. Knowledge of the most common spinal cord neoplasms will allow for appropriate management and optimal patient care.
本文讨论对疑似脊髓肿瘤患者的诊断方法,并回顾最常见的原发性和转移性脊髓肿瘤及其表现。
脊髓肿瘤是罕见的疾病,可累及脊髓实质、硬脑膜和软脑膜,或硬膜外间隙。最常见的脊髓髓内肿瘤是原发性脊髓肿瘤,包括室管膜瘤、毛细胞型星形细胞瘤和弥漫性中线胶质瘤。最常见的脊柱原发性肿瘤是硬膜内髓外脊膜瘤,而软脑膜原发性肿瘤则很罕见。脊髓肿瘤分子特征的进展以及针对这些罕见疾病的近期临床试验正在扩大原发性脊髓肿瘤的全身治疗选择范围。脊柱转移瘤最常累及硬膜外间隙。转移性硬膜外脊髓压迫是一种神经急症,需要迅速采取多学科应对措施以保留神经功能。
神经科医生应了解脊髓肿瘤的诊断方法。了解最常见的脊髓肿瘤将有助于进行适当的管理和为患者提供最佳护理。