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DOI: 10.4103/ajns.AJNS_366_19
Radiologic–Histopathologic correlation of adult spinal tumors: A retrospective study

Aim: Preoperatively performed magnetic resonance images (MRIs) are essential before treating spinal tumors surgically. This study aims to investigate the compatibility of MRI preliminary diagnosis and proven histopathologic diagnosis of consecutively operated 96 spinal tumors. Material and Methods: Medical records were retrospectively reviewed for all spinal tumors operated at our institute during a period of 6 years. One hundred and ten spinal tumors were detected. Fourteen tumors were excluded because they were not met our study criteria. Results: Ninety-six cases of spinal tumors were detected in 46 female and 50 male patients. The mean age was 49.3 ± 22.7 years. The most common symptom was radicular pain (88.6%). Histopathologic diagnoses were metastasis (n = 26), meningioma (n = 16), schwannoma (n = 15), ependymoma (n = 9), astrocytoma (n = 6), chronic nonspecific granulomatous infection (n = 4), lymphoma (n = 3), lipoma (n = 3), epidural tuberculosis abscess (Pott's disease) (n = 3), and other pathologies in 11 cases. Cervical spine was the less spinal region affected with metastases (P < 0.05). Thoracic spine was the most affected spinal region from meningioma (P < 0.05). Preoperatively, preliminary diagnosis on MRIs was proven with histopathologic examinations in 22 metastasis, 14 meningioma, 11 schwannoma, and all epidermoid cyst and lipoma cases. Despite the fact that MRI cannot diagnose all cases of spinal tumors, MRIs had a high accurate rate to diagnose the most common spinal neoplasms (69.8%). Conclusions: Metastases rarely occurred in cervical spine, whereas meningiomas were most likely to occur in thoracic spine. MRIs can help diagnose metastases and spinal benign lesions, whereas they failed to distinguish astrocytomas and lymphomas. Further prospective studies with large size are needed to support our results.
Key-words:
Ependymoma - histopathologic diagnosis - magnetic resonance imaging - meningioma - schwannoma - spinal metastasesFinancial support and sponsorship
Nil.
Publication History
Received: 17 December 2019
Accepted: 24 January 2020
Article published online:
16 August 2022
© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Chikani MC, Okwunodulu O, Mesi M, Mezue WC, Ohaegbulam SC, Ndubuisi CC. Surgically Treated Primary Spinal Cord Neoplasms in Southeastern Nigeria. J Neurosci Rural Pract 2018;9:137-9.
- 2 Emel E, Abdallah A, AF. Taking history and patient assessment in spinal surgery. In: Özer AF, Arslantas A, Dalbayrak S, editors. Principles of Spine Surgery. Vol. 1. Izmir: Intertip Inc.; 2017. p. 99-108.
- 3 Sellin JN, Tatsui CE, Rhines LD. Assessment and treatment of benign intradural extramedullary tumors. In: Winn HR, editors. Youmans and Winn Neurological Surgery. 7th ed. 2017. p. 2428-34.
- 4 Emel E, Abdallah A, Sofuoglu OE, Ofluoglu AE, Gunes M, Guler B, et al. Long-term surgical outcomes of spinal schwannomas: Retrospective analysis of 49 consecutive cases. Turk Neurosurg 2017;27:217-25.
- 5 Sofuoǧlu ÖE, Abdallah A. Pediatric Spinal Ependymomas. Med Sci Monit 2018;24:7072-89.
- 6 Abdallah A, Emel E, Gündüz HB, Sofuoǧlu ÖE, Asiltürk M, Abdallah B. Long-term surgical resection outcomes of pediatric myxopapillary ependymoma: Experience of two centers and brief literature review. World Neurosurg 2019. doi: 10.1016/j.wneu.2019.12.128.
- 7 Witham TF, Khavkin YA, Gallia GL, Wolinsky JP, Gokaslan ZL. Surgery insight: Current management of epidural spinal cord compression from metastatic spine disease. Nat Clin Pract Neurol 2006;2:87-94.
- 8 KlimoPJr., Schmidt MH. Surgical management of spinal metastases. Oncologist 2004;9:188-96.
- 9 Alcalay M, Azais I, Brigeon B, Babin P, Vandermarcq P, Debiais F, et al. Strategy for identifying primary malignancies with inaugural bone metastases. Rev Rhum Engl Ed 1995;62:632-42.
- 10 Brage ME, Simon MA. Evaluation, prognosis, and medical treatment considerations of metastatic bone tumors. Orthopedics 1992;15:589-96.
- 11 Bartels RH, van der Linden YM, van der Graaf WT. Spinal extradural metastasis: Review of current treatment options. CA Cancer J Clin 2008;58:245-59.
- 12 Rosenthal DI. Radiologic diagnosis of bone metastases. Cancer 1997;80:1595-607.
- 13 Norman D, Mills CM, Brant-Zawadzki M, Yeates A, Crooks LE, Kaufman L. Magnetic resonance imaging of the spinal cord and canal: Potentials and limitations. AJR Am J Roentgenol 1983;141:1147-52.
- 14 Daffner RH, Lupetin AR, Dash N, Deeb ZL, Sefczek RJ, Schapiro RL. MRI in the detection of malignant infiltration of bone marrow. AJR Am J Roentgenol 1986;146:353-8.
- 15 Abul-Kasim K, Thurnher MM, McKeever P, Sundgren PC. Intradural spinal tumors: Current classification and MRI features. Neuroradiology 2008;50:301-14.
- 16 Schweitzer ME, Levine C, Mitchell DG, Gannon FH, Gomella LG. Bull's-eyes and halos: Useful MR discriminators of osseous metastases. Radiology 1993;188:249-52.
- 17 Setzer M, Vatter H, Marquardt G, Seifert V, Vrionis FD. Management of spinal meningiomas: Surgical results and a review of the literature. Neurosurg Focus 2007;23:E14.
- 18 Soderlund KA, Smith AB, Rushing EJ, Smirniotopolous JG. Radiologic-pathologic correlation of pediatric and adolescent spinal neoplasms: Part 2, Intradural extramedullary spinal neoplasms. AJR Am J Roentgenol 2012;198:44-51.
- 19 Schaller B. Spinal meningioma: Relationship between histological subtypes and surgical outcome? J Neurooncol 2005;75:157-61.
- 20 Yamaguchi S, Takeda M, Takahashi T, Yamahata H, Mitsuhara T, Niiro T, et al. Ginkgo leaf sign: A highly predictive imaging feature of spinal meningioma. J Neurosurg Spine 2015;23:642-6.
- 21 Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: Radiologic-pathologic correlation. Radiographics 1999;19:1253-80.
- 22 Smith AB, Soderlund KA, Rushing EJ, Smirniotopolous JG. Radiologic-pathologic correlation of pediatric and adolescent spinal neoplasms: Part 1, Intramedullary spinal neoplasms. AJR Am J Roentgenol 2012;198:34-43.
- 23 Seo HS, Kim JH, Lee DH, Lee YH, Suh SI, Kim SY, et al. Nonenhancing intramedullary astrocytomas and other MR imaging features: A retrospective study and systematic review. AJNR Am J Neuroradiol 2010;31:498-503.
- 24 Finn MA, Walker ML. Spinal lipomas: Clinical spectrum, embryology, and treatment. Neurosurg Focus 2007;23:E10.
- 25 Haque S, Law M, Abrey LE, Young RJ. Imaging of lymphoma of the central nervous system, spine, and orbit. Radiol Clin North Am 2008;46:339-61.