What are the most common types of intramedullary spinal cord tumors

The most common types of intramedullary tumors (Table 62-3, Fig. 62-4) are ependymomas, astrocytomas, and hemangioblastomas. In children, astrocytomas are the most common tumor type, while in adults, ependymomas are most common. Ependymomas arise from the cuboidal ependymal cells that surround the ventricular system and central canal of the spinal cord. As the tumor enlarges in the central canal, the flow of CSF is obstructed and cystic cavities frequently develop above and below the lesion. Astrocytomas result from malignant transformation of astrocyte cells, which are glial cells that provide nutritional support to neurons and axons. The majority of tumors are low grade, but more aggressive and infiltrating types occur. These are typically categorized as high-grade or malignant neoplasms. Hemangioblastomas are the most common intramedullary spinal cord tumor of nonglial origin. Hemangioblastomas are tumors that are more commonly seen in patients with von Hippel-Lindau disease.

Table 62-3. Intramedullary Spinal Tumors

Ependymoma

Neuroblastoma

Astrocytoma

Gliomas (malignant oligodendroglioma,

ganglioglioma)

Hemangioblastoma

Epidermoid and dermoid cysts

Lipoma

Spinal cord metastasis

Figure 62-4. Intramedullary spinal cord tumor. Astrocytoma. A, Sagittal T2-weighted magnetic resonance imaging (MRI) reveals an expansile mass in the thoracic spinal cord, representing a World Health Organization grade II astrocytoma. Sagittal T1-weighted MRI before (B) and after (C) gadolinium administration demonstrates heterogeneous enhancement. (From Schapira AHV. Neurology and Clinical Neuroscience. 1st ed. Philadelphia: Mosby; 2007.)

Figure 62-4. Intramedullary spinal cord tumor. Astrocytoma. A, Sagittal T2-weighted magnetic resonance imaging (MRI) reveals an expansile mass in the thoracic spinal cord, representing a World Health Organization grade II astrocytoma. Sagittal T1-weighted MRI before (B) and after (C) gadolinium administration demonstrates heterogeneous enhancement. (From Schapira AHV. Neurology and Clinical Neuroscience. 1st ed. Philadelphia: Mosby; 2007.)

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