Diagnosis of Spinal Tumors

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 7910

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Guest Editor
Department of Orthopedics and Orthopedic, University of Padova, Padova, Italy
Interests: musculoskeletal oncology; orthopedic oncology; orthopedics
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Special Issue Information

Dear Colleagues,

Primary and metastatic tumors of the spine are demanding lesions in terms of diagnosis and management because they are often asymptomatic or have non-specific characteristics. Delayed diagnosis is not very unusual, and sometimes spinal instability or neurological compromise may be the presenting symptom. Optimal diagnosis and treatment of spine tumors require a multidisciplinary approach and thorough knowledge of both spinal surgery and musculoskeletal oncology. This Special Issue highlights the relevance of spinal tumors, particularly related to diagnostic parameters and innovative approaches.

Dr. Andrea Angelini
Guest Editor

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Keywords

  • spinal column
  • sarcoma
  • metastasis
  • spinal neoplasms
  • palliative surgery
  • neurologic symptoms
  • spinal instability
  • benign tumors
  • imaging

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Published Papers (2 papers)

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Research

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8 pages, 595 KiB  
Article
Surgical Site Cytology to Diagnose Spinal Lesions
by Leon-Gordian Koepke, Annika Heuer, Martin Stangenberg, Marc Dreimann, Lutz Welker, Carsten Bokemeyer, André Strahl, Anne Marie Asemissen and Lennart Viezens
Diagnostics 2022, 12(2), 310; https://doi.org/10.3390/diagnostics12020310 - 26 Jan 2022
Cited by 1 | Viewed by 2640
Abstract
Patients with new-onset malignant spinal lesions often have an urgent need for local spine intervention and systemic therapy. For optimal management, it is crucial to diagnose the underlying disease as quickly and reliably as possible. The aim of our current study was to [...] Read more.
Patients with new-onset malignant spinal lesions often have an urgent need for local spine intervention and systemic therapy. For optimal management, it is crucial to diagnose the underlying disease as quickly and reliably as possible. The aim of our current study was to determine the feasibility, sensitivity, specificity, and diagnostic certainty of complementary cytological evaluation of spinal lesions suspected of malignancy. In 44 patients, we performed histopathological biopsies and in parallel cytologic preparations from the malignant site. Cytological smears were prepared and stained for May-Grunwald and Giemsa. Bone biopsies were histopathologically analyzed according to the existing standard-of-care practices. In 42 of 44 cases (95%), a cytological sample was successfully obtained. In 40 cases (95.2%, Cohen’s kappa: 0.77), the cytological diagnosis agreed with the histological diagnosis regarding the identification of a malignant lesion. This resulted in a sensitivity of 97% and a specificity of 80% as well as a diagnostic safety of 95%. Cytological analysis in the context of spinal surgery proved sufficient to establish a diagnosis of malignancy or its exclusion, expanding the existing diagnostic spectrum. Furthermore, implementation of this process as a routine clinical diagnostic might shorten the time to diagnosis and improve the treatment of this vulnerable patient group. Full article
(This article belongs to the Special Issue Diagnosis of Spinal Tumors)
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Review

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26 pages, 5824 KiB  
Review
Diagnosis and Treatment of Lumbar Giant Cell Tumor of the Spine: Update on Current Management Strategies
by Andrew R. Leggett, Ari R. Berg, Heidi Hullinger and Joseph B. Benevenia
Diagnostics 2022, 12(4), 857; https://doi.org/10.3390/diagnostics12040857 - 30 Mar 2022
Cited by 7 | Viewed by 4590
Abstract
(1) Background: Giant Cell Tumor of the spine remains a difficult tumor to treat. Recent advances in adjuvant therapy such as denosumab and innovations in surgical technique in the last 5 years have given providers new options for treatment after a successful diagnosis [...] Read more.
(1) Background: Giant Cell Tumor of the spine remains a difficult tumor to treat. Recent advances in adjuvant therapy such as denosumab and innovations in surgical technique in the last 5 years have given providers new options for treatment after a successful diagnosis of the tumor. (2) Methods: Articles published between 1927 and 2021 were selected from PubMed and Scopus searches using key words “Giant Cell Tumor” AND “Lumbar Spine” AND “Treatment”. Relevant articles were reviewed and selected by the authors. (3) Results: A total of 191 articles were discovered. Complete en bloc spondylectomy remains the most definitive treatment option; however, this surgery is challenging and carries a high rate of complication. New adjuvant therapies including denosumab offer a viable alternative to surgery. (4) En bloc spondylectomy remains the gold standard treatment for Giant Cell Tumor of the spine with the lowest published recurrence rate. The use of (neo)adjuvant denosumab improves recurrence rates. More data are needed to determine if denosumab alone is a viable standalone definitive treatment. Full article
(This article belongs to the Special Issue Diagnosis of Spinal Tumors)
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