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Sarcoma of the spine

Medical expert of the article

Oncologist
, medical expert
Last reviewed: 04.07.2025

Spinal sarcoma is a rare malignant tumor. The disease is one of the most difficult to recognize and diagnose. This is due to physiological and anatomical features, as well as proximity to vital organs and systems.

In the process of diagnosing a neoplasm, an oncologist, a neurosurgeon and a surgeon are involved. Let's look at the features of spinal sarcoma, the causes of the tumor, symptoms, treatment methods and recovery prognosis - this is an oncological disease that is rare and difficult to diagnose. Let's look at the features of spinal sarcoma, the causes of the tumor, symptoms, treatment methods and recovery prognosis.

Spinal sarcoma is extremely rare. The pathology is difficult to diagnose and cure. This is due to the physiological and anatomical features of the disease, as well as the proximity of sarcoma to vital organs and systems. In the process of diagnosing spinal sarcoma, the oncologist has to solve several problems at once. The doctor faces oncological, surgical and neurosurgical tasks.

Tumor processes of this kind are characterized by a wide range of clinical manifestations. This fact is the cause of diagnostic errors and incorrect treatment. There are many types of spinal sarcomas, let's consider them:

  • Osteosarcoma is a malignant lesion of the spinal column and bone tissue.
  • Ewing's sarcoma is the most common pathology in pediatric patients.
  • Chondrosarcoma is a malignant tumor of cartilaginous origin.
  • Metastatic sarcomas of the spine.
  • Fibrosarcoma is a tumor in soft connective tissues, tendons, and muscle fascia.
  • Chordoma is a malignant tumor that affects the spinal cord.
  • Solitary plasmacytoma is a tumor that affects the vertebrae, progresses slowly and is difficult to diagnose.

Each type of spinal sarcoma requires separate diagnostics and specialized treatment. Only professional oncologists and surgeons can recognize the disease.

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Causes of spinal sarcoma

The causes of spinal sarcoma are varied. The disease may appear due to previous injuries and illnesses or arise as a result of metastasis from organs and systems affected by cancer. That is, it is very difficult to determine the exact cause of spinal sarcoma. There is an assumption that the disease appears due to a genetic defect that manifests itself in the process of cell division, even during the intrauterine development of the embryo. Another version of the cause of spinal sarcoma is based on the fact that a tumor growth program is embedded in human tissue and organs, that is, the development of atypical cells. But for their manifestation, there must be certain conditions, that is, provoking factors.

Predisposing factors for spinal sarcoma:

  • Working in conditions of exposure to radiation or in chemical production.
  • Regular violations of the diet.
  • Systematic prolonged exposure to direct sunlight or artificial ultraviolet radiation.
  • Long-term history of smoking (passive smoking is also a predisposing factor).
  • Spinal injuries and defects.

All the above risk factors cause the appearance of malignant neoplasms throughout the body. Tumors develop and metastasize to the spine, causing sarcoma. This is explained by the fact that the spine has a well-developed circulatory system, so malignant pathologies metastasize hematogenously.

Any tumors of the spine can appear from the spinal cord, in the area of the soft meninges that cover the spinal cord. Sarcoma can arise between the soft meninges and the bones of the spinal column. That is, there are many options for sarcoma localization. Many sarcomas have an extradural location. As a rule, these are primary tumors that arise in the spine itself. Much less often, secondary ones, which appear as a result of metastasis from other organs and systems (thyroid gland, prostate, kidneys, lungs, mammary glands). Very rarely, sarcomas are localized near the nerve endings of the spinal cord.

The exact cause of primary spinal tumors is unknown, but they may be genetic defects. By the way, spinal sarcoma, like any other spinal cord tumors, is much less common than malignant brain lesions. As the sarcoma grows, the tissues and roots of the spinal cord, blood vessels, and bone tissues are involved in the pathological process. The disease causes tissue ischemia due to the invasion of sarcoma cells or pressure on the vessels.

As a rule, pain in the lumbar region is not always a sign of a malignant process. Therefore, doctors carefully diagnose the patient's condition, examining the organs for potential causes of a malignant process. Regular preventive examinations, tests and X-rays allow timely detection of malignant formations in the body and prevent the development of spinal sarcoma.

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Symptoms of spinal sarcoma

The symptoms and clinical manifestations of spinal sarcoma depend on a number of factors: at what level of the spine is affected, what type of sarcoma, how quickly the tumor progresses, the degree of spinal cord involvement, the size of the reserve space in the spinal canal and the general health of the patient. The growth rate of the tumor depends on the nature of its occurrence. If the tumor is metastatic, it progresses very quickly. If the tumor is primary, the sarcoma develops slowly, sometimes over 1-2 years.

The symptoms of spinal sarcoma are not immediately recognizable. It is precisely because of such extensive symptoms that the disease is difficult to detect. First of all, it is worth knowing that spinal sarcoma is a malignant formation in the spinal cord or surrounding tissues. The most dangerous symptom of the disease is compression of the spinal cord and nerve roots, which leads to damage to these structures.

The symptoms and clinical manifestations of spinal sarcoma depend on the following factors:

  • At what level of the spine is the sarcoma affected, and in which element did the sarcoma arise?
  • The degree of damage to the spinal cord and its involvement in the pathological process.
  • The tumor is located on the spinal cord (intramedullary) or adjacent to it (extramedullary). If the tumor is extramedullary, then which part of the spinal cord is it adjacent to, the anterior, posterior, or posterolateral.
  • The growth rate of spinal sarcoma and the size of the space in the spinal canal.
  • The general health of the patient, the presence of chronic diseases and pathologies.

Symptoms of spinal sarcoma are distinguished, which depend on the level of damage to the spinal cord. Thus, sarcoma can be located in the cervical, thoracic, lumbosacral spine or in the lower end of the spinal cord. Sarcomas that are within the spinal cord have extensive symptoms, since they affect most of the body. Sarcomas that are outside the spinal cord have a long period of development, so their symptoms are very scanty, and, as a rule, manifest as damage to nerve endings. The rate of growth of sarcoma depends on the nature of its occurrence. If the tumor is secondary, that is, it appeared as a result of metastasis, then it progresses quickly. But primary malignant tumors develop slowly.

Symptoms of malignant tumors of the spine are based on the following types of disorders:

Radicular disorders

This term refers to extramedullary tumors. Sarcoma affects the connective tissue sheaths of the posterior roots. The patient feels severe pain, and a picture of neuralgia of the occipital or intercostal nerves appears. The patient suffers from lumbosacral or cervical-brachial radiculitis.

The pain is shooting, encircling or constricting. The discomfort increases when the patient is in a horizontal position and decreases when standing. Some patients experience a burning sensation in the spine, and symptoms of shingles are possible. But these are clinical manifestations of spinal sarcoma, which successfully disguises itself as other diseases, which greatly complicates the process of diagnosis and treatment.

Segmental disorders

They manifest as motor disorders causing atrophic paralysis and vegetative-vascular disorders. Such disorders arise due to intramedullary tumors of the spine.

Conduction disorders

Characterized by motor disorders that manifest as central paralysis and paresis. The patient develops motor disorders and pelvic disorders. Increased tone of ligaments and muscles, pathological expression of protective and tendon reflexes are possible.

The main symptoms of spinal sarcoma:

  • Muscle weakness and difficulty walking.
  • Back pain (painkillers do not improve the condition), which intensifies when lying down.
  • Fasciculation, muscle spasms, pain in the lower limbs.
  • Burning, itching and tingling of the skin (paresthesia), decreased vestibular function.
  • Cold, clammy skin, feeling of cold in the lower extremities.
  • Paralysis, urinary and fecal incontinence.

It is worth noting that the clinical picture of spinal sarcoma has signs similar to other malignant tumors. Patients have a short history, and the disease itself can develop from several weeks to several years. The patient feels discomfort in the affected area, constant pain that does not stop after taking painkillers and anesthetics. Due to progressive sarcoma, the spine becomes immobile, which significantly complicates the choice of a comfortable position. Patients develop symptoms of pelvic disorders and paralysis.

Spinal sarcoma causes severe pain that can be localized in the affected area or radiate to other parts of the body. At the first stage, sarcoma is not pronounced. But with further progression, it causes an increase in body temperature. Very often, the disease causes spasms of the back muscles, which intensify at night. Sarcoma causes disturbances in the sensitivity of the lower extremities and muscle motor skills. The patient develops gait disturbances, it becomes difficult to walk and maintain balance. If paralysis occurs, this leads to fecal incontinence and the appearance of hematomas and skin changes. Swelling may occur in the spine, which can be palpated. The patient quickly loses weight, feels general weakness and increased fatigue.

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Ewing's sarcoma of the sacral spine

Ewing's sarcoma of the sacral spine is a malignant neoplasm that affects bone tissue. Most often, this type of sarcoma occurs in patients of childhood and young age. The tumor affects the femur, vertebrae, collarbones, pelvic bones, ribs.

To date, doctors have no consensus on the origin of Ewing's sarcoma of the sacral spine. Some are of the opinion that since the spine is rich in nerve pathways and blood vessels, this increases the risk of developing the disease. The peculiarity of this type of sarcoma is that it metastasizes to other bones and the lungs. The symptoms of the disease are increased fatigue and general weakness, sudden weight loss, anemia, fever, local tissue changes, pain, and enlargement of nearby lymph nodes.

Ewing's sarcoma, which affects the sacral spine, is divided into two groups:

  1. Over a long period of time, the sarcoma is confined to one bone. In the later stages, the tumor metastasizes to regional lymph nodes and the lungs. In the final stage, the sarcoma affects other bones.
  2. The second group of the disease is characterized by the fact that the sarcoma quickly destroys the affected vertebra. Within a short period of time, a single focus of the disease metastasizes and becomes multiple. In this case, patients experience symptoms of weakness, back pain, and elevated body temperature.

Ewing's sarcoma is diagnosed by an oncologist. Treatment depends on the stage of the tumor process. Therapy can be carried out using conservative drug methods or surgical intervention methods.

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Diagnosis of spinal sarcoma

Diagnosis of spinal sarcoma is one of the important stages aimed at detecting and developing a further treatment plan for a malignant tumor. Let's look at the main methods used in diagnosing spinal sarcoma:

  • X-ray is the main diagnostic method that allows identifying pathologies in the bone tissue of the spine.
  • Magnetic resonance imaging and computed tomography - the peculiarity of these methods is that they can detect the smallest metastases of sarcoma, determine the exact size of the tumor and its relationship to surrounding organs, tissues, nerves, vessels, and the bone marrow canal.
  • Neurological tests and physiological examination - allow to determine the affects of the neurological system: sensory functions, reflexes, tone and muscle strength.
  • Electroencephalogram (EEG) is a method of measuring electrical conductivity in the spinal column.
  • Biopsy – if sarcoma has affected the bone marrow, this method allows you to find out the type of sarcoma, its stage and the type of cancer cells.

In addition to the above methods, auxiliary methods are also used to diagnose spinal sarcoma. These methods include ultrasound examination, polymerase chain reaction to detect cancer cells in the blood, osteoscintigraphy, microscopic, molecular genetic and immunohistochemical studies.

Very often, spinal sarcoma is detected during an examination, which is carried out to establish the cause of pain in the cervical spine or spine. The X-ray method reveals bone changes in the spine. But to confirm sarcoma, X-rays are not enough. Therefore, for clearer visualization, computed tomography is used. In some cases, if sarcoma in the spine is suspected, the patient undergoes scintigraphy. But laboratory tests are used to clarify the morphology of the malignant tumor and its nature. In addition, the test results allow us to predict possible complications and assume the outcome of the disease, that is, the survival of patients with spinal sarcoma.

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Treatment of spinal sarcoma

Treatment of spinal sarcoma is a complex process, the success of which depends on the diagnosis of malignant neoplasm. The choice of treatment method and the prognosis of patient survival depends on the type of cancer, the degree of spinal damage and the localization of sarcoma. A council of surgeons, oncologists and radiologists works on the development of sarcoma treatment tactics. Modern treatment methods significantly improve the prognosis of malignant disease and allow maintaining a high quality of life for the patient.

Let's look at the main methods of treating spinal sarcoma:

  • Surgical treatment – not all types of sarcomas respond to chemotherapy and radiation therapy, so surgery is used to treat them. The surgeon excises the tumor, the tissue around it, and the nearest lymph nodes.
  • Chemotherapy treatment – Chemotherapy is typically used to treat Ewing’s sarcoma, osteosarcoma, and rhabdomyosarcoma. Other types of sarcoma are less responsive to chemotherapy. Very often, oncologists combine chemotherapy and radiation therapy to achieve the best results.
  • Targeted therapy is a method of pinpoint, i.e. targeted therapy. The goal of such treatment is to eliminate the causes of tumor growth without harming surrounding tissues and organs. This treatment method is highly effective.
  • Intensity-modulated radiation therapy – IMRT is a radiotherapy, i.e. the destruction of spinal sarcoma using radioactive rays. This method is progressive and has proven itself to be highly effective in the treatment of malignant tumors in patients of all ages.
  • Brachytherapy is a method used for deep-seated spinal sarcomas. The essence of the method is that a small capsule is inserted into the affected area, which generates rays and destroys the spinal sarcoma.

More information of the treatment

Prevention of spinal sarcoma

Prevention of spinal sarcoma is a set of methods aimed at preventing the occurrence of the disease. As such, there is no way to completely protect yourself from sarcoma. But timely visits to a doctor and regular check-ups allow you to identify disorders in the body. That is, the sooner spinal sarcoma or any other malignant neoplasm is detected, the greater the chances of successful recovery and complete preservation of health.

Prevention of spinal sarcoma involves:

  • Healthy lifestyle and good nutrition.
  • Limiting contact with carcinogens.
  • Quitting smoking and drinking alcohol.
  • Complete elimination of occupational hazards.
  • Injury prevention.

The main prevention of spinal sarcoma is a healthy lifestyle, injury prevention and timely treatment of diseases. There are certain risk groups that are most susceptible to malignant tumors. The risk group includes people with unfavorable heredity and those exposed to ionizing radiation. Prevention of sarcoma in such patients consists of undergoing routine examinations by an oncologist and taking the necessary tests. Any painful sensations in the spine must be treated, as this may be a symptom of a progressive tumor.

Prognosis of spinal sarcoma

The prognosis for spinal sarcoma depends on a number of different factors.

  • The prognosis of the disease is influenced by the type of sarcoma and its appearance.
  • The treatment tactics and chances of successful recovery depend on the type of malignant neoplasm and the type of spinal sarcoma.
  • The possibility of a radical operation to remove the tumor and the chances of a full recovery depend on the localization of the sarcoma.
  • A positive prognosis depends on the patient’s age, the presence of concomitant diseases, and the absence of metastases in organs and tissues.

All this suggests that the prognosis for spinal sarcoma is individual for each patient. In addition to the main treatment, the prognosis depends on the rehabilitation process, which takes a long period of time. But even timely diagnosis and the use of modern treatment methods do not always guarantee a positive prognosis for spinal sarcoma.

Survival in spinal sarcoma

Survival in spinal sarcoma is determined by the type of malignant tumor, its localization, the chosen treatment tactics and the characteristics of the patient's body. Thus, the prognosis for five-year survival in spinal sarcoma is about 50%. The use of modern drugs and surgical treatment do not guarantee a complete recovery. If the patient has Ewing's sarcoma of the sacral spine, then the patient will have lifelong dispensary observation. Regular examinations allow identifying possible relapses and complications of the disease and increase survival.

Spinal sarcoma is a malignant tumor that is very difficult to diagnose and treat. There are several types of sarcomas that affect the spine. The type of tumor determines the treatment and overall prognosis for recovery. The peculiarity of spinal sarcoma is that the disease is very rare. Timely diagnosis and properly formulated therapy increase the chances of successful recovery.


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