Journal of Neuro-Oncology

, Volume 47, Issue 3, pp 189–194 | Cite as

Surgical Pathology of Intramedullary Spinal Cord Neoplasms

  • Douglas C. Miller


The surgical pathology of intramedullary spinal cord neoplasms is most accurately based on radical resection specimens rather than on small biopsies, which may be highly misleading. A review of the neuropathology files at NYU Medical Center revealed 294 surgical specimens of intramedullary cord lesions examined between January 1, 1991 and December 31, 1998. Of these 117 were from children (age less than 21 years) and 177 were from adults (21 and over). While most types of central nervous system tumors known to occur in the brain also occur in the spinal cord, the different proportions of these tumors by histologic type, and the differences in the proportions of tumor types in children compared to adults, are both significant. In adults ependymomas are the predominant tumor type (93 total) while in children astrocytomas and mixed neuronal-glial tumors are virtually equally common and outnumber ependymomas. In this period no cord Primitive Neuroectodermal Tumors were identified. Among the astrocytic neoplasms and other gliomas, high grade tumors were distinctly uncommon in children and only slightly more common in adults, in sharp contrast with the brain, where the majority of adult intra-axial tumors are high grade.

spinal cord intramedullary neoplasms pathology astrocytoma ependymoma ganglioglioma 


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  1. 1.
    Kepes JJ, Belton K, Roessmann U, Ketcherside WJ: Primitive neuroectodermal tumors of the cauda equina in adults with no detectable primary intracranial neoplasm-three case studies. Clin Neuropathol 4: 1-11, 1985Google Scholar
  2. 2.
    Sibilla L, Martelli A, Farina I, Uggetti C, Zappoli F, Sessa F, Rodriguez Y, Baena R, Gaeltani P: Ganglioneuroblastoma of the spinal cord. Am J Neuroradiol l6: 875-877, 1995Google Scholar
  3. 3.
    Freyer DR, Hutchinson RJ, McKeever PE: Primary primitive neuroectodermal tumor of the spinal cord associated with a neural tube defect. Pediatr Neurosci 15: 181-187, 1989Google Scholar
  4. 4.
    Russell DS, Rubinstein LJ: Pathology of Tumours of the Nervous System. 5th edn., Edward Arnold, London, 1989, p 280Google Scholar
  5. 5.
    Miller DC, Lang FF, Epstein FJ: Central nervous system gangliogliomas, I: Pathology. J Neurosurg 79: 859-866, 1993Google Scholar
  6. 6.
    Lang FF, Epstein FJ, Ransohoff J, Allen JC, Wisoff J, Abbott R, Miller DC: Central nervous system gangliogliomas, II: Clinical Outcome. J Neurosurg 79: 867-873, 1993Google Scholar
  7. 7.
    Patel U, Pinto RS, Miller DC, Handler MS, Epstein FJ, Kricheff II: MRI of spinal ganglioglioma. Am J Neuroradiol 19: 879-887, 1998Google Scholar
  8. 8.
    Constantini S, Houten J, Miller DC, Freed D, Ozek MM, Rorke LB, Allen JC, Epstein FJ: Intramedullary spinal cord tumors in children under the age of three years. J Neurosurg 85: 1036-1143, 1996Google Scholar
  9. 9.
    Miller DC, Rorke LB, Weinberg J, Allen JC, Epstein FJ: Histopathologic diagnoses of intramedullary spinal cord tumors in children. (Abstract) J Neuropathol Exp Neurol 56: 607, 1997Google Scholar
  10. 10.
    Robertson PL, Allen JC, Abbott IR, Miller DC, Fidel J, Epstein FE: Cervicomedullary tumors in children: Adistinct subset of brainstem gliomas. Neurology 44: 1798-1803, 1994Google Scholar
  11. 11.
    Squires LA, Constantini S, Miller DC, Epstein F: Diffuse infiltrating astrocytoma of the cervicomedullary region: Clinicopathologic entity. Pediatr Neurosurg 27: 153-159, 1998Google Scholar
  12. 12.
    Miller DC, Koslow MK, Budzilovich GN, Burstein DE: Synaptophysin:Asensitive and specific marker for ganglion cells in central nervous system neoplasms. Hum Pathol 21: 271-276, 1990Google Scholar
  13. 13.
    Hassoun J, Gambarelli D, Grisoli F, Pellet W, Salamon G, Pellisier JF, Toga M: Central neurocytoma. An electron microscopic study of two cases. Acta Neuropathol (Berl) 56: 151-156, 1982Google Scholar
  14. 14.
    Figarella-Branger D, Pellissier JF, Daumas-Duport C, Delisle MB, Pasquier B, Parent M, Gambarelli D, Rougon G, Hassoun J: Central neurocytomas. Critical evaluation of a small-cell neuronal tumor. Am J Surg Pathol 16: 97-109, 1992Google Scholar
  15. 15.
    Giangaspero F, Cenacchi G, Losi L, Cerasoli S, Bisceglia M, Burger PC: Extraventricular neoplasms with neurocytoma features. A clinicopathological study of 11 cases. Am J Surg Pathol 21: 206-212, 1997Google Scholar
  16. 16.
    Hamilton R: Frontal lobe tumor in 11 year old girl. Brain Pathol 7: 713-714, 1997Google Scholar
  17. 17.
    Hassoun J, Soylemezoglu F, Gambarelli D, Figarella-Branger D, von Ammon K, Kleihues P: Central neurocytoma: A synopsis of clinical and histological features. Brain Pathol 3: 297-306, 1993Google Scholar
  18. 18.
    Miller DC: New perspectives on neuronal neoplasms. (Abstract) Brain Pathol 7: 1139-1140, 1990Google Scholar
  19. 19.
    Nishio S, Takeshita I, Fukui M: Primary cerebral ganglioneurocytoma in an adult. Cancer 66: 358-362, 1990Google Scholar
  20. 20.
    Min KW, Cashman RE, Brumback RA: Glioneurocytoma: Tumor with glial and neuronal differentiation. J Child Neurol 10: 219-226, 1995Google Scholar
  21. 21.
    Kawano N, Yada K, Aihara M, Yagishita S: Oligodendroglioma-like cells (clear cells) in ependymoma. Acta Neuropathol (Berl) 62: 141-144, 1983Google Scholar
  22. 22.
    Louis DN, Swearingen B, Linggood RM, Dickersin GR, Kretschmar C, Bhan AK, Hedley-Whyte ET: Central nervous system neurocytoma and neuroblastoma in adults-report of eight cases. J Neuro-Oncol 9: 231-238, 1990Google Scholar
  23. 23.
    Tatter SB, Borges LF, Louis DN: Central neurocytomas of the cervical spinal cord. Report of 2 cases. J Neurosurg 81: 288-293, 1994Google Scholar
  24. 24.
    Coca S, Moreno M, Martos JA, Rodriguez J, Barcena A, Vaquero J: Neurocytoma of the spinal cord. Acta Neuropathol (Berl) 87: 537-540, 1994Google Scholar
  25. 25.
    Zhang PC, Rosenblum MK: Synaptophysin expression in the human spinal cord. Diagnostic implications of an immunohistochemical study. Am J Surg Pathol 20: 273-276, 1996Google Scholar
  26. 26.
    Quinn B: Synaptophysin staining in normal brain: Importance for diagnosis of ganglioglioma. Am J Surg Pathol 22: 550-556, 1998Google Scholar
  27. 27.
    Minehan KJ, Shaw EG, Scheithauer BW, Davis DL, Onofrio BK: Spinal cord astrocytoma: Pathological and treatment considerations. J Neurosurg 83: 590-595, 1995Google Scholar
  28. 28.
    Rossitch E Jr, Zeidman SM, Burger PC, Curnes JT, Harsch C, Anscher M, Oakes WJ: Clinical and pathological analysis of spinal cord asorocytomas in children. Neurosurgery 27: 193-196, 1990Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Douglas C. Miller
    • 1
  1. 1.Departments of Pathology (Division of Neuropathology) and NeurosurgeryNew York University School of Medicine, and the Kaplan Comprehensive Cancer Center of NYUNew YorkUSA

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