Spinal Tumors

Question 1

Spinal bone marrow before the age of 7 contains more _____ marrow and therefore ____ on MRI.

Answer 1

red enhances

Question 2

Osteoid osteomas are most commonly found in the spine at _______.

Answer 2

lumbar neural arch (rarely in the bodies)

Question 3

What is usually seen on CT with osteoid osteomas?

Answer 3

dense sclerotic bone around a lytic lesion with a central calcified nidus of osteoid and woven bone less than 2 cm (if bigger, think osteoblastoma)

Question 4

Which bone tumor pain responds to ASA?

Answer 4

osteoid osteoma

Question 5

What is the most common location for an osteoblastoma in the spine?

Answer 5

cervical spine, posterior elements

Question 6

Giant cell tumors are rare in the spine but if present, the most common location is the ____.

Answer 6

Sacrum

Question 7

Where is the most common location for osteochondroma in the spine?

Answer 7

C2 spinous process or transverse processes at other levels

Question 8

Where do osteochondromas arise from and how do the appear on imaging?

Answer 8

lateral displacement of the epiphyseal growth cartilage and have a bony projection with a medullary cavity contiguous with the parent bone and covered with cartilage

Question 9

Where is the most common location for aneurysmal bone cysts in the spine?

Answer 9

posterior elements of cervical and thoracic spine

Question 10

When is seen on imaging of aneurysmal bone cysts?

Answer 10

multiloculated, expansile, lytic, vascular, and surrounded by eggshell cortical bone and no calcifications

Question 11

What is seen on microscopic evaluation of aneurysmal bone cysts?

Answer 11

reveals thin-walled blood cavities without endothelium or elastic lamina and frequent multinucleated giant cells

Question 12

Eosinophilic granuloma is in the _______ group of diseases and classically is a cause of ______ in the spine.

Answer 12

Langerhans cell histiocytosis

vertebrae plana

Question 13

What is the key phrase for chordoma on pathology?

Answer 13

physaliphorous cells

Question 14

What is the most common primary sacral tumor?

Answer 14

chordoma

Question 15

What is seen on CT with osteosarcoma?

Answer 15

matrix calcifications with a sunburst pattern

Question 16

What are the three most common metastatic tumors to the epidrual space in the spine in adults? In children?

Answer 16

breast, lung, prostate

Ewing’s sarcoma, neuroblastoma

Question 17

Which mets to the spine can be sclerotic/blastic?

Answer 17

breast and prostate

Question 18

Epidural lipmatosis is associated with _____.

Answer 18

obesity and steroid use

Question 19

What is the most common spinal tumor?

Answer 19

Nerve sheath tumors, particularly schwannomas

Question 20

What is the difference in relation between the nerve and the tumor in schwannomas vs neurofibromas?

Answer 20

Question 21

What percent of patients with nerve sheath tumors have NF?

Answer 21

40%

Question 22

Within the spinal canal, which compartment do nerve sheath tumors lie in?

Answer 22

intradural/extramedullary (70%), extradural (15%), dumbbell (15%), and intramedullary (1%)

Question 23

Meningiomas account for what percent of spinal tumors?

Answer 23

25%

Question 24

In what compartment do meningiomas lie within the spine?

Answer 24

intradural (90%), extradural (5%), and dumbbell (5%)

Question 25

Paragangliomas in the spine are rare but if found, are most commonly in ____.

Answer 25

cauda equina

Question 26

Neurenteric cysts in the spine are generally located in the _____ spine and are ____ to the cord.

Answer 26

throacic

ventral

Question 27

Intradural metastatic spinal cord tumors (including primary CNS tumors) have a mortality rate of ____ in _____.

Answer 27

80% in 4 months

Question 28

What is the most common intramedullary tumor in adults?

Answer 28

ependymoma (60%)

Question 29

In the spnie, cellular ependymomas are most commonly in the _____ while myxopapillary are most commonly in the ____.

Answer 29

cervical

conus/filum

Question 30

What is the most common intramedullary spinal tumor in children?

Answer 30

astrocytoma

Question 31

What subtype of astrocytoma is most commonly in the spine?

Answer 31

fibrillary