Challenges in diagnosis and management of adult spinal cord gliomas

Rev Neurol (Paris). 2021 May;177(5):515-523. doi: 10.1016/j.neurol.2021.02.384. Epub 2021 Apr 23.


Intramedullary spinal cord gliomas have very low incidence rates. They are associated with difficulties in diagnosis and treatment, and cause significant morbidity. Their clinical presentation and their appearance at magnetic resonance imaging are not specific. They can mimic inflammatory, infectious, vascular disorders or other neoplastic lesions. Primary treatment is surgery. Surgical resection can often be total for ependymomas, but difficult for infiltrating astrocytomas. Radiotherapy is indicated for malignant tumors, but remains controversial in some indications. Chemotherapy is reserved for recurrence, but small retrospective series are available. Genetic studies have revealed genetic alterations which could have a potential impact on treatment in the near future.

Keywords: Astrocytoma; Ependymoma; Magnetic resonance imaging; Molecular markers; Spinal cord glioma.

Publication types

  • Review

MeSH terms

  • Astrocytoma* / diagnosis
  • Astrocytoma* / therapy
  • Ependymoma* / diagnosis
  • Ependymoma* / therapy
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Spinal Cord
  • Spinal Cord Neoplasms* / diagnosis
  • Spinal Cord Neoplasms* / therapy