Epidemiology

Intramedullary spinal cord tumors account for approximately 2-4% of all tumors in the central nervous system¹.

Location

Intramedullary spinal cord tumors can occur at all levels of the spinal cord, but are most common in the cervical spinal cord, followed by the thoracic and lumbar regions. The cause of this distribution is not fully understood, but it is assumed that the higher proportion of gray matter in the cervical spinal cord accounts for the highest tumor incidence there².

Tumor	Incidence³	Location⁴
Ependymoma	Most common	Cervical > thoracic > lumbar
Astrocytoma	Second most common	Cervical > thoracic > lumbar
Myxopapillary ependymoma	Rare	Filum terminale and conus medullaris
Hemangioblastoma	Very rare. Increased incidence in patients with von Hippel-Lindau disease	Cervical > thoracic > lumbar
Germ cell tumor	Very rare	Cervical > thoracic > lumbar
Ganglioglioma	Rare	Cervical > thoracic > lumbar
Primary CNS lymphoma	Rare	Cervical > thoracic > lumbar
Melanoma	Very rare	Cervical > thoracic > lumbar

Imaging

MRI is the gold standard for imaging intramedullary spinal cord tumors.

Intramedullary diffuse midline glioma, WHO Grade 4, on MRI — MRI of a patient with a histopathologically confirmed intramedullary diffuse midline glioma, WHO Grade 4.

Intramedullary mass on MRI — Intramedullary spinal cord tumor on sagittal and axial MRI images (T2 sequence).

Intramedullary subependymoma on MRI — Visualization of a histopathologically verified intramedullary subependymoma in the cervical spine on various MRI sequences.

Intramedullary ependymoma on MRI — Visualization of a histologically confirmed intramedullary ependymoma (WHO Grade II) on various MRI sequences.

References

Tobin, Matthew K., et al. "Intramedullary spinal cord tumors: a review of current and future treatment strategies." Neurosurgical focus 39.2 (2015): E14. ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩