SPINAL TUMOURS

Abstract

The majority of spinal tumours are due to metastasis, however the most common primary tumour is multiple myeloma. This is a retrospective study of patients presenting with tumours of the spine, determining the incidence of malignant and benign tumours presenting at King George V spinal unit.

All admissions from January 2004 to April 2006 were reviewed. Age, gender, presenting complaint, clinical presentations, and tumour type were evaluated. The tumour type was diagnosed by laboratory, radiological and histological investigations. Histology was obtained by either closed or open biopsy. Laboratory investigations included a full blood count, liver function tests, urea and electrolytes, serum and urine protein electrophoresis.

Of the 42 patients diagnosed, 25 were male (59.5%) and 17 were female (40.5%). The average age was 50 (range 10 to 82). All patients presented with pathological pain and 34 patients presented with neurology ranging from mild weakness to complete paralysis (frankel D to A). 8 had no neurology. 16 Patients (38.1%) were diagnosed by closed biopsy, 23 (54.8%) by open biopsy, and 3 patients (7.1%) were diagnosed by clinical biochemical, and radiological investigations as multiple myeloma (they demised prior to biopsy). 9 Patients had a benign tumour (21.4%) and 33 had a malignant tumour (78.6%). 12 Patients had a primary tumour (36.4%), and 21 had secondary deposits (63.6%). The benign tumours included 2 Aneurysmal bone cysts, 2 Giant cell tumours, 3 haemangioma’s, 1 osteoblastoma and 1 osteochondroma. The primary malignant tumours included 1 Ewings sarcoma, 1 lymphoma, 1 ependymoma, and 9 myeloma. The secondary tumours included 17 undifferentiated metastatic adenocarcinomas, 2 renal cell cancers, 1 nephroblastoma, and 1 follicular thyroid cancer. Patients were managed by a multi-disciplinary team.

Malignant spinal tumours are most likely due to metastasis. Males have a greater risk than females with a peak incidence in the 5^th decade.