Nonenhancing tumors of the spinal cord

J. Bradley White, Gary M. Miller, Kennith F. Layton, William E. Krauss

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Object. Enhancement of pathological entities in the central nervous system is a common finding when the blood-brain barrier has been compromised. In the brain, the presence or absence of gadolinium enhancement is often an indicator of tumor invasiveness and/or grade. In the spinal cord, however, contrast enhancement has been shown in all tumor types, regardless of grade. In this study the authors explore the incidence of nonenhancing tumors of the spinal cord and the clinical course of patients with these lesions. Methods. A retrospective analysis was conducted in which investigators examined the patterns of enhancement of histologically proven intramedullary spinal cord tumors that had been evaluated at the Mayo Clinic between 1998 and 2002. The tumors that did not enhance were the subject of this report. Results. A total of 130 patients with intramedullary tumors were evaluated. Of those, 11 patients (9%) had tumors that did not enhance. Histologically, a majority of tumors were astrocytomas (eight low-grade and two high-grade lesions); one tumor was a subependymoma. Morphologically, most of the tumors were diffuse and none had associated cysts. Tumors spanned from two to seven levels and were located throughout the spinal cord (four cervical, three cervicothoracic, one thoracic, and three thoracolumbar). Biopsy procedures were performed in eight patients, subtotal resection was performed in two, and gross-total resection in one. After a mean follow-up period of 19 months, tumors remained stable in eight patients but progressed in three, two of whom died. Conclusions. A number of intramedullary spinal cord tumors will not enhance after addition of contrast agents. The absence of enhancement does not imply the absence of tumor.

Original languageEnglish (US)
Pages (from-to)403-407
Number of pages5
JournalJournal of Neurosurgery: Spine
Volume7
Issue number4
DOIs
StatePublished - Oct 2007

Keywords

  • Contrast enhancement
  • Intramedullary lesion
  • Spinal cord neoplasm

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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    White, J. B., Miller, G. M., Layton, K. F., & Krauss, W. E. (2007). Nonenhancing tumors of the spinal cord. Journal of Neurosurgery: Spine, 7(4), 403-407. https://doi.org/10.3171/SPI-07/09/10/403