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What is a Metastatic Tumor (Secondary Tumor)?

A tumor (lump or mass) in your spine is an abnormal growth of tissue within or around your spinal column or spinal cord.

A metastatic tumor is a lump in your spine that is produced by cancer elsewhere in your body. It is the more common type of tumor in the spine. Though metastatic tumor can occur anywhere along your spine, most happen in your thoracic (mid-to-upper back) region. 

Causes of Metastatic Tumors

Cancer cells that originated and developed in other parts of your body typically reach the spine via the bloodstream or by means of direct extension. The most common cancers that spread to your spine include breast, lung, prostate, colon, and thyroid in that order.  

Signs and Symptoms

Back pain that occurs suddenly and does not improve with rest is the typical sign of a metastatic tumor. 

Additional symptoms tend to occur several days following the onset of the back pain include: 

  • Pain that gets worse during night or upon waking 
  • Pain that shoots down your legs and arms
  • Weakness or clumsiness in your legs or arms
  • Tingling or numbness along your legs or arms
  • Shooting pain in lower back and hip (sciatica)
  • Aching pain in the bones
  • Bowel or bladder problems

These symptoms may be experienced separately or in combination.

What if Metastatic Tumors are Left Untreated?

If untreated, the symptoms can get worse over time and result in: 

  • Weak or fractured bones
  • Compression of nerve endings
  • Spinal deformity 
  • Eventually, partial paralysis 

Diagnosis

Diagnosis of metastatic tumors begins with medical history taking and a physical examination, followed by blood tests and biopsy (examination of tissue). 

The diagnosis is further confirmed through imaging tests like:

  • X-Ray
  • CT scan
  • MRI 

Treatment 

Treatment of metastatic tumors in your spine normally necessitates a multidisciplinary approach and can be non-surgical or surgical.

Non-surgical treatments 

Non-surgical options typically include the use of any of the following: 

  • Analgesics, steroids or corticosteroids
  • Medications such as NSAIDs or opioids
  • Drugs like RANKL inhibitors and bisphosphonates
  • Back braces, radiation therapy and chemotherapy

Surgical treatments 

Surgery for metastatic tumors usually involves either partial or complete removal of the tumor via an open or a minimally invasive procedure. 

Potential surgical options are:

  • Spinal column reconstruction
  • Spinal fusion  
  • Microsurgery, laser surgery
  • Stereotactic radiosurgery 
  • Vertebroplasty
  • Corpectomy or cordotomy 
  • Embolization (limiting the blood flow to the tumor) 

The surgery, regardless of type, is likely to be followed by chemotherapy sessions to eliminate any remaining cancer cells.  

The exact type of treatment depends upon factors like the location of the tumor in your spine, current cancer treatment and your medical condition.

  • American Academy of Orthopaedic Surgeons
  • North American Spine Society
  • Cobb County Medical Society
  • Georgia Orthopaedic Society
  • Piedmont Clinic