Primary Benign Neoplasms of the Spine

Abstract

Benign tumours comprise the majority of primary vertebral tumours, and these are often found incidentally on imaging. Nonetheless, accurate diagnosis of these benign lesions is crucial, in order to avoid misdiagnosis as more ominous malignant lesions or infection. Furthermore, some of these tumours, despite their benign nature, can have localised effects on the spine including neural compromise, or can be locally aggressive, thus necessitating active management. Haemangiomas and osteomas (enostosis) are the commonest benign tumours encountered. Others include osteoid osteoma, osteoblastoma, fibrous dysplasia, osteochondroma, chondroblastoma, haemangioma, simple bone cysts, aneurysmal bone cysts, giant cell tumours, eosinophilic granuloma and notochordal rests. The majority of lesions are asymptomatic; however, locally aggressive lesions (such as aneurysmal bone cysts or giant cell tumours) can present with nonspecific symptoms, such as back pain, neurological deficits and spinal instability, which may be indistinguishable from more commonly encountered mechanical back pain or malignant lesions including metastases. Hence, imaging, including radiography, computed tomography (CT) and magnetic resonance imaging (MRI), plays a critical role in diagnosis. Generally, most incidental or asymptomatic regions are conservatively managed or may not require any follow-up, while symptomatic or locally aggressive lesions warrant active interventions, which include surgical resection or percutaneous treatment techniques. Due to advances in interventional radiology techniques in recent years, percutaneous minimally invasive techniques such as radiofrequency ablation, sclerotherapy and cryoablation have played an increasing role in the management of these tumours with favourable outcomes. The different types of primary benign vertebral tumours will be discussed in this article with an emphasis on pertinent imaging features.

Diagnostic and Therapeutic Insights into Spinal Glomangioma of a Unique Intradural, Extramedullary Presentation—Systematic Review

“…Certain malignant primary [ 7 , 8 , 9 , 10 ] or metastatic [ 11 , 12 ] intradural lesions, although infrequent, may resemble their primary counterparts; however, their initial management differs as it typically requires adjunct oncological treatment [ 13 , 14 ]. Among the less commonly encountered non-malignant tumors are ependymomas, hemangiomas, lipomas, paragangliomas, vascular neoplasms, nerve sheath myxoma, and other exceptionally rare entities, including the seldom-described glomus tumors of the spinal canal [ 15 , 16 ].…”

Benign Notochordal Cell Tumours: Case Report and Literature Review

“…Golden et al conducted a study of 916 patients, using CT and MRI to examine the posterior clivus, and documented that the imaging prevalence of BNCTs was 0.76% [3]. Although BNCTs are generally considered benign, their histological characteristics can mimic more aggressive neoplasms, such as chordomas or chondrosarcomas, posing challenges in accurate diagnosis and treatment planning [4]. The common locations of BNCTs are similar to those of chordomas, and in rare cases, a BNCT has been reported to co-exist with a chordoma.…”