Giant Primary Spinal Bony Extra-Axial Tumors: Case Series and Literature Review

Aim: Aim of this study is to study cases of giant primary spinal bony tumours (maximum diameter- >5cm) operated in a single institute including presentation, imaging, management and follow up with histopathological diagnosis.

Study: Case series with retrospective analysis of data

Place and duration – single center study with data collected from Jan 2011 to Nov 2023 in Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.

Methodology: This is retrospective analysis of primary spinal bony tumours who underwent surgery in a single institute from Jan 2011 up to Nov 2023 with minimum follow-up of 1 month. We assessed a total of 27 patients who underwent surgery for bony spinal tumors with size >5cm. Of these 10 cases were excluded as biopsy came out to be metastases. Five cases were excluded as they were recurrent cases and three cases lost to follow up. So, a total of 9 patient’s data was tabulated and analyzed. We analyzed presentation, imaging, treatment and outcome of these patients with review of literature.

Results: Mean age of presentation for benign tumors was 24.5 years whereas it was 46 years for malignant tumors. Mean duration of presentation for benign lesion was 15.75 months whereas for malignant lesions it was 3.4 months. 5 cases out of 9 (55%) were in dorsal region, 1 case (11.11%) in cervicothoracic region and 3 cases (33.33%) were in sacral region. All patients presented with symptoms of back pain, 7 (77.77%) had motor symptoms, 5(55%) presented with sensory symptoms and 5(55%) with bladder bowel. Out of 4 benign lesion one underwent intralesional excision, rest underwent marginal en bloc excision. Out of 5 malignant lesion one underwent intralesional excision, rest underwent marginal en bloc excision. Out of 4 benign lesions two patients (50%) did not show any improvement at 1 month follow up. Out of 5 malignant lesion 1 patient (20%) did not show any improvement at 1 month follow up.

Conclusion: Giant primary bony spinal tumours are rare entities. Early diagnosis and surgical treatment are paramount for tumour control and functional improvement.