Skip to main content

Advertisement

SpringerLink
Log in

Intramedullary spinal cord tumors in pediatric patients presenting later with brain lesions: case series and systematic review of the literature

  • Research
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Purpose

Intramedullary spinal cord tumors are an uncommon pathology in adults and children. Most descriptive studies of intramedullary spinal cord tumors have not focused on a possible association with future brain lesions. To the best of our knowledge, few reports describe this potential relationship. This is one of the most extensive case series of secondary brain lesions of intramedullary spinal cord tumors in the pediatric population.

Methods

Retrospective chart review was performed on pediatric patients (21 years old and younger) who underwent resection of an intramedullary spinal cord tumor at two tertiary care hospitals from 2001 to 2020. Patients previously treated or diagnosed with spinal cord tumor, and subsequent development of intracranial manifestation of the same or different tumor, were included. Data regarding epidemiology, surgical intervention, and clinical and follow-up course were gathered. Data analysis was performed according to a standardized clinical protocol with a literature review.

Result

More than 500 patients underwent intradural spinal tumor resection surgeries at participating hospitals from 2001 to 2020. After excluding adult patients (older than 21 years old) and those with extramedullary lesions, 103 pediatric patients were identified who underwent resection of an intramedullary spinal cord tumor. Four underwent resection of an intermedullary tumor and later in their follow-up course developed a secondary intracranial neoplasm. In every case, the secondary neoplasm had the same pathology as the intramedullary tumor. Three of the patients had tumors at the cervico-thoracic junction, and one patient had a high cervical tumor. These patients had a negative primary workup for any metastatic disease at the time of the presentation or diagnosis. Complete and near complete resection was performed in three patients and subtotal in one patient.

Conclusion

Secondary brain tumors disseminated after initial spinal cord tumor are extremely rare. This study aims to allow specialists to better understand these pathologies and treat these rare tumors with more certainty and better expectations of unusual associated lesions and conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

IMSCT:

Intramedullary spinal cord tumor

LP:

Lumbar puncture

MRI:

Magnetic resonance imaging

References

  1. Mechtler LL, Nandigam K (2013) Spinal cord tumors: new views and future directions. Neurol Clin 31(1):241–268

    Article  PubMed  Google Scholar 

  2. Ostrom QT, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS (2021) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014–2018. Neuro-Oncology 23(3):1–105. https://doi.org/10.1093/neuonc/noab200

    Article  Google Scholar 

  3. Tihan T, Chi JH, McCormick PC et al (2006) Pathologic and epidemiologic findings of intramedullary spinal cord tumors. Neurosurg Clin N Am 17:7–11

    Article  PubMed  Google Scholar 

  4. Kaballo MA, Brennan DD, El Bassiouni M et al (2011) Intramedullary spinal cord metastasis from colonic carcinoma presenting as Brown-Sequard syndrome: a case report. J Med Case Rep 5:342

    Article  PubMed  PubMed Central  Google Scholar 

  5. Endo H, Kumabe T, Jokura H, Shirane R, Ariga H, Takai Y et al (2003) Leptomeningeal dissemination of cerebellar malignant astrocytomas. J Neurooncol 63:191–199

    Article  PubMed  Google Scholar 

  6. Figueiredo EG, Matushita H, Machado AG, Plese JP, Rosemberg S, Marino R Jr (2003) Leptomeningeal dissemination of pilocytic astrocytoma at diagnosis in childhood. Arq Neuropsiquiatr 61:842–847

    Article  PubMed  Google Scholar 

  7. David KF, Casey A, Hayward R D, Harkness W, Phipps K, Wade AM (1997) Medulloblastoma: is the 5-year survival rate improving? - a review of 80 cases from a single institution

  8. Kesari S, Batchelor TT (2003) Leptomeningeal metastases. Neurol Clin 21:25–66

    Article  PubMed  Google Scholar 

  9. Chamdine O, Broniscer A, Wu S, Gajjar A, Qaddoumi I (2016) Metastatic low-grade gliomas in children 20 years’ experience at St Jude Children’s Research Hospital. Pediatr Blood Cancer. 63(1):62–70. https://doi.org/10.1002/pbc.25731. Epub 2015 Aug 27. PMID: 26312767; PMCID: PMC5122937

    Article  PubMed  Google Scholar 

  10. Agha RA, Sohrabi C, Mathew G, Franchi T, Kerwan A, O’Neill N, PROCESS Group (2020) The PROCESS 2020 Guideline Updating Consensus Preferred Reporting Of CasE Series in Surgery (PROCESS) Guidelines. Int J Surg. S1743–9191(20):30779–2

    Google Scholar 

  11. Buschmann U, Gers B, Hildebrandt G (2003) Pilocytic astrocytomas with leptomeningeal dissemination: biological behavior, clinical course, and therapeutical options. Childs Nerv Syst 19:298–304

    Article  PubMed  Google Scholar 

  12. Minehan KJ, Shaw EG, Scheithauer BW, Davies DL, Onofrio BM (1995) Spinal cord astrocytoma: pathological and treatment considerations. J Neurosurg 83:590–595

    Article  CAS  PubMed  Google Scholar 

  13. Gajjar A, Bhargava R, Jenkins JJ et al (1995) Low-grade astrocytoma with neuraxis dissemination at diagnosis. J Neurosurg 83:67–71

    Article  CAS  PubMed  Google Scholar 

  14. Civitello LA, Packer RJ, Rorke LB, Siegel K, Sutton LN, Schut L (1988) Leptomeningeal dissemination of low-grade gliomas in childhood. Neurology 38:562–566

    Article  CAS  PubMed  Google Scholar 

  15. Onda K, Tanaka R, Takahashi H, Takeda N, Ikuta F (1989) Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy. Neurosurgery 25(4):533–540

    Article  CAS  PubMed  Google Scholar 

  16. Ng HK, Leung CH, Boet R, Poon WS (2001) Spinal cord pilocytic astrocytoma with cranial meningeal metastases. J Clin Neurosci 8(4):374–377

    Article  CAS  PubMed  Google Scholar 

  17. Mamelak AN, Prados MD, Obana WG, Cogen PH, Edwards MSB (1994) Treatment options and prognosis for multicentric juvenile pilocytic astrocytoma. J Neurosurg 81:24–30

    Article  CAS  PubMed  Google Scholar 

  18. Akyurek S, Chang EL, Yu T-K, Little D, Allen PK, McCutcheon I et al (2006) Spinal myxopapillary ependymoma outcomes in patients treated with surgery and radiotherapy at M.D. Anderson Cancer Center. J Neurooncol 80(2):177–83. https://doi.org/10.1007/s11060-006-9169-2

    Article  PubMed  Google Scholar 

  19. Foote RL, Stafford SL, Petersen IA et al (2012) The clinical case for proton beam therapy. Radiat Oncol 7:174. https://doi.org/10.1186/1748-717X-7-174

    Article  PubMed  PubMed Central  Google Scholar 

  20. Morikawa M, Tamaki N, Tokunai T et al (1997) Cerebellar pilocytic astrocytoma with leptomeningeal dissemination: case report. Surg Neurol 48:49–52

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute for Brain Protection Science, Johns Hopkins All Children’s Hospital, 601 5th St S, Suite 511, St. Petersburg, FL, 33701, USA

    Bassel Bali & George I. Jallo

  2. Department of Neurosurgery, University of South Florida, Tampa, FL, USA

    Bassel Bali, Angel Chinea & George I. Jallo

  3. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Bassel Bali, George I. Jallo & Nir Shimony

  4. Institute for Clinical and Translational Research, Johns Hopkins All Children’s Hospital, 601 5th St S, Suite 511, St. Petersburg, FL, 33701, USA

    Austin Sellers

  5. Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Nir Shimony

  6. Le Bonheur Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA

    Nir Shimony

  7. Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA

    Nir Shimony

  8. Semmes-Murphey Clinic, Memphis, TN, USA

    Nir Shimony

Authors
  1. Bassel Bali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Austin Sellers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angel Chinea
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. George I. Jallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nir Shimony
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

B.B., A.S., and A.C. participated in data collection. A.S. and B.B. formatted tables and figures. All authors contributed to manuscript drafting, as well as substantive reviews and edits of the manuscript.

Corresponding author

Correspondence to George I. Jallo.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bali, B., Sellers, A., Chinea, A. et al. Intramedullary spinal cord tumors in pediatric patients presenting later with brain lesions: case series and systematic review of the literature. Childs Nerv Syst 40, 1079–1089 (2024). https://doi.org/10.1007/s00381-024-06311-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-024-06311-0

Keywords

Search

Navigation