Details of Osteoma osteoid and osteoblastoma

They are both osteogenic tumour and are histologically identical but they differ for size: while osteoma has 1 cm maximum diameter, osteoblastoma has at least 1,5cm of diameter. They occur especially in young male (under 20 years). They prefer posterior element of the vertebra and they may be associated to scoliosis. They are characterized by night pain which responds to NSAID and aspirin.

Details of Osteochondroma

It is a tumour which origins by cartilage tissue. It prefers cervical level and occurs most frequently in young male (20-30 years). It is usually asymptomatic but it may occasionally manifests itself with symptom and signs of compression.

Details of Vertebral hemangiomas

They represent the most common benign primary spinal tumour. They are vascular tumours which incidence peak of 10%. They arise as two types: cavernous (most common) and capillary (rare). They are commonly asymptomatic (>98,8%); symptoms may include compression fracture, disc herniation and very rarely neural compression.

Details of Aneurysmal bone cyst

It represent 15% of all spine tumours . It is a tumour-like osteolytic lesion consisting of highly vascular honeycomb of blood-filled cavities separated by connective tissue septa and surrounded by thin cortical bone. It may arise from pre-existing tumour or following acute fracture. It prefers young female ad usually occurs in sacral-lumbar level. It is commonly symptomatic (pain or painful fractures).

Details of Giant cell tumours (AKA osteoclastoma)

They are tumours that arise from osteoclasts. They prefer knee and wrist but occasionally can occur in skull and column (nearly 4% occurs in sacrum).

Eosinophilic granuloma (AKA Unifocal Langerhans cell hystiocytosis)

It is a eosinophilic rich lesion which is more frequent in young male (under 10 years). It may be solitary or multiple and it usually occurs in cervical level. It can be symptomatic (night pain sensitive to NSAID). It is highly radiosensitive.

Characteristics of Chordomas

They are rare tumours of the remnant of the primitive notochord. They are generally slow-growing tumours which can occur both in skull (clivus) and columns (sacral level). They are characterized by high recurrence rate (85%) following surgery.

Characteristics of Osteosarcoma

It is a malignant bone tumour that may origin ex novo or as a result of benign bone tumour involution. It may also origin from pre-radiated tissue or in patient with Paget disease. It is very aggressive and it destroy bone tissue and surrounded ones. Local pain is the most common symptom at the onset. 

Characteristics of Chondrosarcoma

It is a malignant tumour of cartilage. It prefers male and occurs commonly in adulthood (5th-6th decade). Local pain and neural compression signs and symptoms are frequent at the onset. 

Characteristics of Ewing’s sarcoma

It is a malignant mesenchimal tumour with unknown origin. It prefers male and it is typical of pediatric age. More than 50% occurs in sacral level and they prefer anterior element of the vertebra (on the contrary of benign tumour). Treatment aim is palliative and it consists of radical excision followed by RTX and chemotherapy. 

Characteristics of Plasmacytoma

It is an ematologic tumour which occurs adulthood and prefers male. 

Characteristics of Multiple myeloma

It is a tumour (1% of all) which origins from plasma cell. It represents 1% of all ematologic tumours. It frequently afflicts bone and causes osteolysis. Clinically they are characterized by pain and fractures.

Features of Meningiomas

They are more frequent in adulthood (peak age 40-70 years) and they prefer female (F:M ratio = 4:1) more likely due to hormonal influences, that’s why they may rapidly grow during pregnancy.
Meningiomas most frequently occur at thoracic level followed by cervical and lumbar ones.
They origin from arachnoid cells and they are benign (WHO grade I) in most cases. They arise as solitary lesion or less frequently as multiple ones. They usually appear as round masses that constrict spinal cord without invading it and that’s why the onset key symptom is pain. 

Features and classifications of Neurinomas and neurofibromas

They are more frequent in adulthood but they also can afflict young people (especially in case of neurofibromas among Neurofibromatosi I e II). Not detectable gender difference. 
Neurinomas (AKA Schwannomas) origin from Schwann’s cell while neurofibromas origin from mesenchymal cell belonging to fibroblastic series.
They frequently arise from dorsal (sensitive) rootlets (75%) and they may grow along the longitudinal axis of the nerve involved. They are capsulated and well circumscribed. They can appear as:

• Entirely Intradural (most frequently)
• Completely extradural
• Combination of intra and extradural
• Dumbbell tumours: they are tumours that develop an “hourglass” shape as a result of an anatomic barrier encountered during growth.

The are subdivided according to Asazuma classification system as following:
Type I - Both intradural and extradural but restricted to spinal canal
Type II - Extradural and foraminal constriction
Type III - Both intradural and extradural with foraminal constriction
Type IV - Extradural and intravertebral
Type V - Extradural and extralaminar with laminar invasion
Type VI - Extradural with multidirectional bone erosion

Features of Ependymoma

Ependymoma can be considered both extra-medullary due to surgical approach and intra-medullary due to histological origin from ependymal cells.
They are more frequent in adulthood (on the contrary of brain ependymomas).
They are usually situated at conus medullaris or filum terminale and they represent the most common glioma of lower cord.
They usually are solitary and of the myxopapillary subtype (WHO grade I).

Features of Astrocytoma

It is common in adulthood, with peak age: 30-50 years. It is little more frequent in male.
It occurs at all levels but more frequently at thoracic one. 
Astrocytomas may be both low and high grade with ratio 3:1.

Clinical Note

Ependymoma and astrocytoma represent more than 90% of all IMSCT in paediatrics 

References

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Related topics

Tumors - Scores and Classifications

Degenerative Spine - Classifications and Scales