Intradural-Extramedullary Tumors lie INSIDE the DURAL
covering of the Spinal Canal but OUTSIDE the SUBSTANCE
of the SPINAL CORD. Patients usually experience PAIN as
a PRIMARY SYMPTOM. They often develop WEAKNESS IN ONE OR MORE
EXTREMITIES (most often starting in their legs) once the
pressure on the Spinal Cord and/or Spinal Nerve Roots is
Most of the INTRADURAL-EXTRAMEDULLARY TUMORS are BENIGN although some
are MALIGNANT. Both varieties are reviewed in the material that follows
in this section. We also invite your interest in a more detailed review
of some illustrated cases in our
SPINAL CORD TUMOR CASE STUDY SECTION.
(Nerve Sheath Tumors) comprise the overwhelming majority of this
subset of Spinal Tumors. Meningiomas arise from the
Arachnoid (a thin covering layer of the Spinal Cord
which is located inside the Dura Mater) and are MOST
COMMON IN MIDDLE AGED and ELDERLY WOMEN. The Thoracic portion of the
Vertebral Column is the most commonly affected part of the Spine.
Schwannomas and Neurofibromas arise from the Nerve Roots which
come off the Spinal Cord. Neurofibromas can occur as
a sporadic condition or as a genetic disorder such
Meningiomas, Neurofibromas and Schwannomas are almost
always entirely histologically benign. There are some
additional, although exceptionally rare, tumors that are included
in this group of benign tumors such as
Epidermoids and Dermoids.
The latter two (2) are more common in children.
Please see ILLUSTRATED
"SPINAL CORD TUMOR CASE STUDIES"
on this website for additional information.
The role of surgery is somewhat limited since
complete removal is unlikely. However,
"de-bulking" (decreasing the over-all size) of the Tumor
can be very effective in controlling the severe pain that
is commonly associated with these conditions along with
improving the neurological condition that had been
associated with compression of the Neural elements by the
Tumor. An additional benefit is achieving biopsy
confirmation of the Tumor type. There is also the possibility
of submitting samples of the Tumor for tissue culture and
subsequently testing various chemotherapeutic agents against this
Tumor before initiating treatment of the patient. (See next
paragraph for further comment)
The treatment of these unusual Malignant Tumors must be designed
specifically for the Tumor type which commonly requires both
Radiation Therapy and Chemotherapy.
Some medical centers are involved in "Clinical Trials" of
various chemotherapeutic agents for these difficult to treat tumors.
Among the techniques that they may choose to utilize is
submitting a sample of the tumor for tissue culture. In
this way they are able to "grow" the tumor outside the body
and subject it to separate methods of analysis including
the particular tumor cell's susceptibility to various chemotherapeutic agents.
While there is some controversy related to this, patients affected
by these conditions might do well to learn more about it.
The case illustrated here is that of a "CHLOROMA" in a 14 year
old male with Acute Myelogenous Leukemia. A
Minimally Invasive Microsurgical Resection
of the majority of this Intradural-Extramedullary Tumor
was accomplished followed by Radiation Therapy and
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This page last edited on 2/19