Spinal Cord Tumors in Children: Causes, Types, and Treatments

What are spinal cord tumors?

Spinal cord tumors are a mass of abnormal cells that form within or around the spinal cord. These abnormal cells, also known as neoplasms or tumors, can be either benign (non-cancerous) or malignant (cancerous).

Regardless of their type, growth in the spinal cord can lead to neurological issues since it pressures and compresses the spinal cord. Early diagnosis and treatment are important to prevent permanent damage, ensuring that your child can retain a good quality of life.

What causes spinal cord tumors in children?

As of now, there’s no definitive cause for this condition. However, researchers believe that genetic conditions may disrupt the necessary cell division process for proper body growth.

Errors in this process can result in abnormal cell mutations, which can lead to tumors. Here are some conditions that can increase the risk of spinal cord tumors in children, such as:

• Neurofibromatosis

  • This term encompasses three genetic diseases, neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis, that cause mutations in the genes.

  • These conditions increase the likelihood of developing tumor cells in the nervous system, including the spinal cord.

• Li-Fraumeni syndrome

  • This syndrome is a rare genetic disorder that’s associated with an increased risk of abnormal cell growth. 

• Tuberous sclerosis

  • A rare genetic condition that causes non-cancerous growth to form in multiple organs, including the brain and spinal cord.

• Von Hipple-Lindau disease 

  • This hereditary condition causes the formation of non-cancerous growth called hemangioblastomas in different areas of the body. 

  • These masses of cells are made of newly formed blood vessels, with cysts (fluid-filled sacs) around them.

  • Although usually non-cancerous, this disease can cause serious or life-threatening complications if not treated properly. 

• Idiopathic:

  • In some cases, spinal cord tumors can occur without a clear, identifiable cause.

Types of spinal cord tumors in children

Spinal cord tumors in children can be categorised according to their location, whether they originate from inside the spinal cord or the surrounding tissues.

The types of abnormal growth that can occur are as follows:

Intramedullary tumors 

In this type of tumor, abnormal cells grow within the spinal cord itself. Most intramedullary tumor are classified as gliomas, which originate from the glial cells that nourish and support the neurones in the brain and spinal cord. 

Tumor types of intramedullary tumors are:

• Astrocytomas: 

  • Astrocytomas are one of the most common types of intramedullary tumor in children. This growth develops from star-shaped astrocyte cells within the spinal cord, which provide supportive tissue to the brain.

  • This condition can either be non-cancerous or cancerous and can develop slowly over time or progress rapidly.

• Ependymomas:

  • These neoplasms develop from ependymal cells that line the central canal of the spinal cord. This intramedullary tumor tends to grow slowly and usually doesn’t spread to other parts of the body.

• Ganglioglioma:

  • These are rare growths that are composed of both neuronal (cells from the neurones in the brain) and glial cells. 

  • This neoplasm is generally slow-growing and non-cancerous and usually doesn’t spread to other parts of your body.

Intradural-extramedullary tumors

This type of tumor develops outside the spinal cord but still within the spinal canal. It can originate in the protective meninges surrounding the spinal cord or in the nerve roots extending from it.

Although these growths are usually non-cancer, they can still exert pressure on the spinal cord, leading to neurological symptoms.

• Meningioma:

  • This neoplasm develops from the meninges, the layers of tissue that surround the brain and spinal cord. Although rare in children, when they do occur, meningiomas are usually benign and slow-growing.

• Schwannoma:

  • This type of tumor originates from Schwann cells, which form the protective layer around peripheral nerves.

  • Schwannomas can also grow on the peripheral nerves (which convey electrical signals from the brain to the the body) or nerve roots (where the peripheral nerve joins the spinal cord.)

  • They are generally benign but may cause significant symptoms due to compression of nearby structures. 

Extradural tumors

These growths develop outside the outer protective layer of the spinal cord. Though less common in children, it can lead to severe compression of the spinal cord if it grows large enough. 

Here are some types of extradural tumor that can happen in children, such as:

• Osteosarcomas and Ewing's Sarcoma:

  • These are aggressive bone tumors that can affect the vertebrae, which protect the spinal cord.

  • As the osteosarcomas and Ewing's sarcomas grow, these neoplasms can compress the spinal cord, causing significant neurological conditions, even paralysis in severe cases.

• Chordomas:

  • This is a rare bone growth that usually occurs at the base of the spine or skull. Chordomas are slow-growing neoplasms but can be difficult to treat due to how they invade nearby nervous system tissue.

• Metastatic tumors:

  • Although rare, neoplasms that begin in other parts of the body can travel to the spine through the blood system. 

  • In children, certain conditions like sarcomas or neuroblastoma can spread to the spine and cause extradural tumor.

Other conditions

In addition to the causes mentioned above, there are other growths that can lead to the development of spinal cord tumor.

• Dermoid and epidermoid cysts:

  • These non-cancerous growths develop from skin cells that were trapped under the surface of the skin during foetal development.

  • They are usually slow-growing and can compress the spinal cord, causing symptoms similar to other spinal cord tumor.

• Teratomas:

  • Teratomas are a rare condition that is made up of several different types of tissue, such as muscle, bone, or fat.

  • It can occur anywhere along the spinal column and may cause compression of the spinal cord or nerve roots.

Common symptoms

The symptoms of spinal cord tumors in children can vary depending on the location, size of the growth, and type of the condition. But in general, there are several common signs that parents should watch out for, including:

• Pain and discomfort

  • Children may experience persistent back or neck pain, which might be accompanied by headaches. 

  • This condition is exacerbated, particularly when the neoplasms affect the upper spine. The pain usually worsens over time and may become severe enough to disrupt sleep and reduce quality of life.

• Movement and coordination difficulty

  • Parents might notice their child having difficulty walking or displaying unusual clumsiness, often accompanied by muscle weakness in their arms or legs. 

  • These balance and coordination problems may become noticeable during daily activities.

• Spinal deformity: 

  • Spinal deformities, such as scoliosis, in the spine can change how the child stands or walks. This condition occurs in up to one-third of children with spinal cord tumors.

  • Some children develop visible spinal deformities or noticeable swelling along the spine. These physical changes often affect how the child stands or walks, creating noticeable differences in their posture and movement patterns.

• Neurological impairment:

  • Children may experience numbness or tingling sensations in their arms or legs, sometimes accompanied by bladder dysfunction and loss of bowel control.

  • Some cases may involve seizures and progressive muscle weakness, along with loss of sensation in the sensory organ.

If parents notice their child shows the symptoms mentioned above, it is important to seek medical attention right away. This action was necessary to prevent permanent damage to the spinal cord because of delayed treatment.

But early detection might be difficult because spinal cord tumors develop slowly over time and may be confused with normal growing pains. Other than that, each child's experience varies significantly, and young children often struggle to express their symptoms clearly.

We recognise that parents may feel concerned when their child experiences discomfort or limited mobility.  

Our care team at Thomson Medical is here to listen to your concerns and provide the support you need. Request an appointment with us to get expert advice and personalised treatment plans tailored to your child's needs.

Diagnosis of spinal cord tumor in children

To diagnose the spinal cord tumors in children, a care team of a paediatric neurologist or neurosurgeon may check the kid’s medical history and do a physical exam along with a neurological exam.

During this assessment, the healthcare professional will check your child’s nerve function, brain condition, ability to walk, and talk.

To help diagnose and identify any underlying conditions, healthcare professionals may perform imaging tests and additional assessments, which include:

• Magnetic Resonance Imaging (MRI): 

  • An MRI procedure is used for detecting spinal cord tumors by providing detailed images of the spine and surrounding tissues.

• Computed Tomography (CT) scans: 

  • CT scans can help identify both primary tumors as well as metastatic growth, along with other changes in the spine.

• Cerebrospinal fluid analysis 

  • This analysis is conducted to assess various substances within the cerebral fluid. It also aids in identifying cancer cells in other areas of the body that may have travelled to the central nervous system.

• Blood tests: 

  • Along with imaging tests, blood tests can indicate the presence of “tumor markers," or abnormal substances in the blood caused by certain types of cancer cells.

• Biopsy: 

  • In some cases, a biopsy is necessary to determine the exact type of growth. This involves removing a small sample of growth tissue for examination under a microscope.

What are the available treatments for spinal cord tumors in children?

Treatment for spinal cord tumors in children depends on several factors, including tumor type, location, and the child's overall health.

This condition requires treatment in a hospital environment, involving professional care such as from radiation oncologists, paediatric neurologists, and paediatric neurosurgeons.

• Surgery

  • Surgery usually serves as the primary treatment for spinal cord tumors. The goal is to remove the neoplasms while minimising damage to the surrounding nerves and spinal cord.

  • However, in some cases, complete removal may not be possible, especially if the growth is deeply embedded or affects vital structures. In this condition, partial removal can still relieve symptoms and improve the child’s quality of life.

• Radiation therapy

  • Radiation therapy may be used if there's cancer cells that cannot be fully removed through surgery. High-energy radiation is directed at the abnormal cells to shrink them or slow their growth.

  • This treatment is often used cautiously in children to reduce the risk of potential long-term impacts on the developing spine and nervous system.

• Chemotherapy

  • Chemotherapy is commonly used for cancerous spinal cord tumors, especially in cases of metastatic cancer cells. 

  • It may be used in combination with surgery or radiation therapy to treat tumors that have spread or are difficult to remove surgically.

• Targeted therapy and immunotherapy

  • Newer treatments, such as targeted therapies and immunotherapies, are being explored as potential new treatments for spinal cord tumors in children. 

  • These therapies aim to specifically target cancer cells while sparing healthy tissues, reducing side effects compared to traditional chemotherapy.

• Clinical trials

  • This method is a form of treatment that is still in the trial phase and is not yet applicable in real-world settings. These trials serve as a means to assess new cancer therapies.

  • Throughout the course of a clinical trial, data is gathered regarding the effects and efficacy of a new treatment. If a trial demonstrates that a new treatment outperforms existing options, it may be adopted as standard practice.

FAQ

Are spinal tumors common in children?

Spinal tumors are a relatively rare condition in children. However, regular visits to your paediatrician are still necessary to help monitor and support the healthy development of a child.

What is the most common tumor in children?

The most common tumors in children include:

• Astrocytomas

• Ependymomas

• Neuroblastoma

• Bone cancer (including osteosarcoma and Ewing sarcoma)

What is the success rate of spinal cord tumor removal?

The success rate of spinal cord tumor removal varies depending on factors such as tumor type, location, and your child's overall health. In cases where a tumor is deeply embedded or affects vital structures, complete removal may not be possible.

However, partial removal can be an alternative solution to relieve symptoms and improve your kid's quality of life.

What is the most common age for spinal tumors?

Spinal tumors can develop at any age, but primary spinal growth is more frequently diagnosed in adults aged 65 to 74 and in children aged 10 to 16.

How quickly do spinal tumors grow?

The growth rate of spinal tumors varies by type. Primary spinal growth usually progresses slowly over weeks or years, while metastatic growth (those that have spread from other parts of the body) can develop more rapidly.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request for an appointment with Thomson Medical today.