Radiologic-Histopathologic Correlation of Adult Spinal Tumors: A Retrospective Study

Asian J Neurosurg. 2020 May 29;15(2):354-362. doi: 10.4103/ajns.AJNS_366_19. eCollection 2020 Apr-Jun.

Abstract

Aim: Preoperatively performed magnetic resonance images (MRIs) are essential before treating spinal tumors surgically. This study aims to investigate the compatibility of MRI preliminary diagnosis and proven histopathologic diagnosis of consecutively operated 96 spinal tumors.

Material and methods: Medical records were retrospectively reviewed for all spinal tumors operated at our institute during a period of 6 years. One hundred and ten spinal tumors were detected. Fourteen tumors were excluded because they were not met our study criteria.

Results: Ninety-six cases of spinal tumors were detected in 46 female and 50 male patients. The mean age was 49.3 ± 22.7 years. The most common symptom was radicular pain (88.6%). Histopathologic diagnoses were metastasis (n = 26), meningioma (n = 16), schwannoma (n = 15), ependymoma (n = 9), astrocytoma (n = 6), chronic nonspecific granulomatous infection (n = 4), lymphoma (n = 3), lipoma (n = 3), epidural tuberculosis abscess (Pott's disease) (n = 3), and other pathologies in 11 cases. Cervical spine was the less spinal region affected with metastases (P < 0.05). Thoracic spine was the most affected spinal region from meningioma (P < 0.05). Preoperatively, preliminary diagnosis on MRIs was proven with histopathologic examinations in 22 metastasis, 14 meningioma, 11 schwannoma, and all epidermoid cyst and lipoma cases. Despite the fact that MRI cannot diagnose all cases of spinal tumors, MRIs had a high accurate rate to diagnose the most common spinal neoplasms (69.8%).

Conclusions: Metastases rarely occurred in cervical spine, whereas meningiomas were most likely to occur in thoracic spine. MRIs can help diagnose metastases and spinal benign lesions, whereas they failed to distinguish astrocytomas and lymphomas. Further prospective studies with large size are needed to support our results.

Keywords: Ependymoma; histopathologic diagnosis; magnetic resonance imaging; meningioma; schwannoma; spinal metastases.