2012 Volume 26 Issue 3 Pages 284-292
Primary spinal and paraspinal bone tumors are rare, with most lesions arising because of metastasis. According to the bone tumor registry of the Japanese Orthopaedic Association, the most frequent origin of bone metastases is lung carcinoma. The most frequent primary bone tumor is chordoma, followed by hemangioma and giant cell tumor of bone. For diagnosis of bone tumors, a range of clinical data are to be considered, including age, gender, clinical course, and history, together with the results of imaging, cytogenetic, and histological studies. Imaging studies are particularly important as the tumors have shown particular imaging characteristics. With regard to treatment, most of the many benign tumors do not require surgical intervention. For those with severe, uncontrollable pain, or disability, treatment usually involves curettage, resection, or arterial embolization. Malignant tumors such as those of the Ewing sarcoma/primitive neuroectodermal family, rhabdomyosarcoma, and malignant lymphoma should be treated with chemotherapy. Wide or curative resection of the tumor is often impossible because of adjacent major visceral organs or the risk of severe disability after surgery. Recent advances in radiotherapy, including proton beam or carbon ion techniques, have also shown efficacy. Other recent advances worth noting include a newly recognized disease, such as benign notochordal cell tumor, and new treatments such as molecular targeted therapy utilizing anti-receptor activator of nuclear factor-κB ligand antibody against giant cell tumor of bone.
