Primary Spine Tumors: Diagnosis and Treatment

Michelle J. Clarke, MD; Ehud Mendel, MD; Frank D. Vrionis, MD, PhD


Cancer Control. 2014;21(2):114-123. 

In This Article


Clinical Presentation

Most patients with primary spine tumors present incidentally or following a workup for nonspecific axial skeletal pain. As these tumors often originate in the vertebral body, symptoms are usually due to periosteal stretching with growth and localized bony destruction. Thus, unremitting pain that worsens at night or in the supine position is common.[3] Mechanical pain due to instability may be reported. Radicular or myelopathic symptoms due to neurological element compression are rare. A new or progressive deformity, especially in younger patients, may be a presenting feature. If a tumor is suspected, or if a patient has persistent symptoms, then imaging studies should be pursued. Important clinical features and implications for treatment that distinguish primary from metastatic spine lesions are noted in Table 1.