42:. Intradural tumors are located inside the dura mater lining and are further subdivided into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the dura and spinal cord parenchyma, while intradural-extramedullary tumors are located within the dura but outside the spinal cord parenchyma. The most common presenting symptom of spinal tumors is nocturnal back pain. Other common symptoms include
354:
amenable to resection than intramedullary tumours, and even possible to be operated through microendoscopic or pure endoscopic approaches. In patients with metastatic tumors, treatment is palliative with the goal of improving the patient's quality of life. In these cases, indications for surgery include pain, stabilization, and spinal cord decompression.
321:(STIR) is also commonly added to the MRI protocol for detecting spinal cord tumors. Myelography may be used as a substitute when the patient cannot undergo an MRI or it is unavailable. X-rays and CT are more commonly used to view the bony structures. They are less frequently used for spinal cord tumors, however, since they cannot reliably detect them.
1322:
Patchell, Dr. Roy A.; Tibbs, Phillip A.; Regine, William F.; Payne, Richard; Saris, Stephen; Kryscio, Richard J.; Mohiuddin, Mohammed; Young, Byron (20 August 2005). "Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial".
268:
The diagnosis of spinal tumors is challenging, as the symptoms can be non-specific and often mimic more common and benign degenerative spinal diseases. A comprehensive medical examination is necessary to look for signs or symptoms that may point towards a more serious condition. This includes a
353:
Surgery has several indications depending on the type of tumor, which includes complete resection, decompression of the nerves, and stabilization. An attempt at total gross resection for a possible cure is an option for patients with primary spinal cord tumors. Extramedullary tumours are more
85:
Treatment often involves some combination of surgery, radiation, and chemotherapy. Observation with follow-up imaging may be an option for small, benign lesions. Steroids may also be given before surgery in cases of significant cord compression. Outcomes depend on a number of factors including
370:
are possible options as an adjunct to surgery or for tumors not amenable to surgery. Intradural-extramedullary tumors are often benign, so observation with follow-up imaging is an option in cases where the lesions are small and the patient is asymptomatic. Radiotherapy and chemotherapy may be
394:, either metastatic or primary. Some suggest that direct decompressive surgery combined with postoperative radiotherapy, provide better outcomes than treatment with radiotherapy alone for patients with spinal cord compression due to metastatic cancer.
98:
The symptoms of spinal tumors are often non-specific, resulting in a delay in diagnosis. Spinal nerve compression and weakening of the vertebral structure cause the symptoms. Pain is the most common symptom at presentation. Other common symptoms of
1965:
1950:
375:, type of tumor, and amount of surgical resection achieved. In cases where radiotherapy is chosen, radiation is usually delivered to the involved segment in the spinal cord and the uninvolved segment above and below the involved segment.
206:
Intradural tumors are located within the dura mater. These are further broken down into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the spinal cord itself, with the most common being
238:
Common primary cancers in metastatic spinal tumors includes breast, prostate, lung, and kidney cancer. It is important to diagnose and promptly treat metastatic tumors as they can lead to long-term neurologic deficit from epidural
804:
Hamamoto, Yasushi; Kataoka, M.; Senba, T.; Uwatsu, K.; Sugawara, Y.; Inoue, T.; Sakai, S.; Aono, S.; Takahashi, T.; Oda, S. (9 May 2009). "Vertebral
Metastases with High Risk of Symptomatic Malignant Spinal Cord Compression".
186:
at the lumbar spine. Most symptoms from spinal tumors occur due to compression of the spinal cord as it plays a primary role in motor and sensory function. The spinal cord is surrounded by three layers known as the spinal
53:
The cause of spinal tumors is unknown. Most extradural tumors are metastatic commonly from breast, prostate, lung, and kidney cancer. There are many genetic factors associated with intradural tumors, most commonly
34:. There are three main types of spinal tumors classified based on their location: extradural and intradural (intradural-intramedullary and intradural-extramedullary). Extradural tumors are located outside the
1907:
1807:
1525:
1466:
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Imaging is often the next step when the diagnosis is unclear or there is greater suspicion for a serious condition that may need immediate intervention. Common types of medical imaging include
333:
Treatment greatly varies depending on the type of spinal cord tumors, goals of care, and prognosis. The primary forms of treatment include surgical resection, radiotherapy, and chemotherapy.
82:. Diagnosis involves a complete medical evaluation followed by imaging with a CT or MRI. A biopsy may be obtained in certain cases to categorize the lesion if the diagnosis is uncertain.
908:
Holt, T.; Hoskin, P.; Maranzano, E.; Sahgal, A.; Schild, S.E.; Ryu, S.; Loblaw, A. (6 March 2012). "Malignant epidural spinal cord compression: the role of external beam radiotherapy".
162:
are commonly seen in patients with suppressed immune systems. The majority of extradural tumors are due to metastasis, most commonly from breast, prostate, lung, and kidney cancer.
345:. These do not affect the tumor mass itself, but tend to reduce the inflammatory reaction around it and decrease the overall volume of the mass impinging on the spinal cord.
1308:
1438:
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to confirm or exclude spinal metastasis. Rapid identification and intervention of metastatic spinal cord compression is necessary to preserve neurologic function.
488:
273:
focusing on any motor or sensory deficits. Patients with either benign degenerative spinal disease or spinal tumors often present with back pain. A patient with
1288:
1770:
203:. Spinal cord tumors are classified based on their location within the spinal cord: intradural (intradmedullary and extramedullary) and extradural tumors.
1891:
1815:
1739:
1368:"The combined use of surgery and radiotherapy to treat patients with epidural cord compression due to metastatic disease: a cost-utility analysis"
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administered alone or in conjunction with surgery. The choice of chemotherapy or radiotherapy is a multidisciplinary process and depends on the
1069:
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219:. Intradural-extramedullary tumors are located within the dura but outside of the spinal cord parenchyma, with the most common being
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Furlan, J.C.; Chan, K.K.; Sandoval, G.A.; Lam, K.C.; Klinger, C.A.; Patchell, R.A.; Laporte, A.; Fehlings, M.G. (May 2012).
123:. The diagnosis is challenging, primarily because symptoms often mimic more common and benign degenerative spinal diseases.
63:
1572:
1744:
1617:
1243:""Microendoscopic" versus "pure endoscopic" surgery for spinal intradural mass lesions: a comparative study and review"
758:
Nambiar, Mithun; Kavar, B (2012). "Clinical presentation and outcome of patients with intradural spinal cord tumours".
235:). Extradural tumors are located outside the dura mater most commonly in the vertebral bodies from metastatic disease.
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379:
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The cause of the majority of spinal tumors is currently not known. Primary spinal tumors are associated with a few
1829:
59:
243:. Primary extradural tumors are rare and most arise from surrounding bony and soft tissue structures, including
1980:
1668:
1663:
1455:
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Chamberlain, Marc C.; Tredway, Trent L. (2011-06-01). "Adult
Primary Intradural Spinal Cord Tumors: A Review".
270:
86:
whether the tumor is benign or malignant, primary or metastatic, and location of the tumor. Treatment is often
55:
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is a new technique for treating spinal tumors. This treatment can be tailored to the particular tumor of the
1447:
342:
240:
100:
1289:"When cancer spreads to the spine, a new operation can cut both hospital and recovery time - NY Daily News"
708:
Mechtler, Laszlo L.; Nandigam, Kaveer (2013-02-01). "Spinal Cord Tumors: New Views and Future
Directions".
1919:
Note: Not all brain tumors are of nervous tissue, and not all nervous tissue tumors are in the brain (see
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1582:
1516:
864:
814:
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is a primary symptom of spinal cord compression in patients with known malignancy. Back pain may prompt a
309:. MRI is the imaging of choice for spinal tumors. The MRI protocol that is most frequently used includes
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often occur in the later stages of the disease. Children may present with spinal deformities such as
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may be used as a supplementary imaging modality for tumors involving bony structures of the spine.
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Jennelle, Richard L. S.; Vijayakumar, Vani; Vijayakumar, Srinivasan (2 August 2011).
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996:"A Systemic and Evidence-Based Approach to the Management of Vertebral Metastasis"
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Spinal cord compression is commonly found in patients with metastatic malignancy.
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Ribas, Eduardo S. C.; Schiff, David (1 May 2012). "Spinal Cord
Compression".
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66:(VHL) syndrome. The most common type of intradural-extramedullary tumors are
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is a long, cylindrical anatomical structure that is located within the
1139:
Bilsky, Mark H. (2005-11-01). "New therapeutics in spine metastases".
1954:
1712:
1545:
43:
459:. Arnautović, Kenan I.,, Gokaslan, Ziya L. Cham, Switzerland. 2018.
158:
can be seen in patients with von Hippel-Lindau disease. Spinal cord
16:
Neoplasms located in either the vertebral column or the spinal cord
290:
46:
weakness, sensory loss, and difficulty walking. Loss of bowel and
1420:
150:
are associated with neurofibromatosis 1 (NF1). Meningiomas and
74:. The most common type of intradural-intramedullary tumors are
1908:
WHO classification of the tumors of the central nervous system
1192:"Delay In Diagnosis of Primary Intra Dural Spinal Cord Tumors"
317:
sequences, including contrast enhanced T1-weighted sequences.
154:
are associated with neurofibromatosis 2 (NF2). Intramedullary
509:
Gossman, William; Hoang, Stanley; Mesfin, Fassil B. (2019),
682:"Spinal Tumors – Types, Symptoms, Diagnosis and Treatment"
50:
control may occur during the later stages of the disease.
681:
546:
Balériaux, D. L. F. (1999-08-01). "Spinal cord tumors".
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Segal D, Constantini S. C.; Korn, Lidar (14 May 2012).
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910:Current Opinion in Supportive and Palliative Care
281:raises suspicion for a more serious condition.
616:Burton, Matthew R.; Mesfin, Fassil B. (2019),
341:) may be administered if there is evidence of
107:, numbness in hands and legs, and rapid onset
1432:
1309:"Spinal Tumors | Mount Sinai - New York"
8:
90:for the vast majority of metastatic tumors.
1771:Embryonal tumour with multilayered rosettes
951:Reith, W.; Yilmaz, U. (December 2011). "".
511:"Cancer, Intramedullary Spinal Cord Tumors"
1933:
1550:
1541:
1521:
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1439:
1425:
1417:
1241:Dhandapani, S; Karthigeyan, M (Sep 2018).
1090:Current Neurology and Neuroscience Reports
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487:: CS1 maint: location missing publisher (
1391:
1217:
1207:
1021:
1011:
868:
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753:
751:
749:
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1892:Malignant peripheral nerve sheath tumor
1816:Primary central nervous system lymphoma
1740:Dysembryoplastic neuroepithelial tumour
850:
848:
846:
618:"Cancer, Conus And Cauda Equina Tumors"
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857:Current Treatment Options in Neurology
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807:Japanese Journal of Clinical Oncology
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1578:Subependymal giant cell astrocytoma
1141:Expert Review of Neurotherapeutics
14:
1766:Atypical teratoid rhabdoid tumor
760:Journal of Clinical Neuroscience
1860:Cranial and paraspinal nerves
1:
1573:Pleomorphic xanthoastrocytoma
1448:Tumours of the nervous system
1337:10.1016/S0140-6736(05)66954-1
38:lining and are most commonly
1618:Anaplastic oligodendroglioma
1259:10.1016/j.spinee.2018.02.002
922:10.1097/spc.0b013e32834de701
319:Short-TI Inversion Recovery
2077:
772:10.1016/j.jocn.2011.05.021
380:minimally invasive surgery
299:Magnetic resonance imaging
1916:
1102:10.1007/s11910-011-0190-2
1062:10.1007/978-3-540-44715-3
965:10.1007/s00117-011-2152-8
879:10.1007/s11940-012-0176-7
722:10.1016/j.ncl.2012.09.011
624:, StatPearls Publishing,
517:, StatPearls Publishing,
103:include muscle weakness,
2061:Nervous system neoplasia
1745:Lhermitte–Duclos disease
1669:Choroid plexus carcinoma
1664:Choroid plexus papilloma
1153:10.1586/14737175.5.6.831
1050:Surgery of Spinal Tumors
712:. Spinal Cord Diseases.
295:computer tomography scan
1209:10.4103/2152-7806.96075
343:spinal cord compression
241:spinal cord compression
101:spinal cord compression
1588:Anaplastic astrocytoma
1583:Fibrillary astrocytoma
358:Non-Surgical Treatment
26:located in either the
1844:Esthesioneuroblastoma
1568:Pilocytic astrocytoma
1384:10.1093/neuonc/nos062
560:10.1007/s003300050831
491:) CS1 maint: others (
1849:Ganglioneuroblastoma
1754:CNS embryonal tumors
1659:Choroid plexus tumor
182:of the skull to the
117:bladder incontinence
1692:Gliomatosis cerebri
1294:New York Daily News
1013:10.5402/2011/719715
829:10.1093/jjco/hyp039
378:The combination of
264:Medical Examination
225:nerve sheath tumors
178:. It runs from the
72:nerve-sheath tumors
60:neurofibromatosis 2
56:neurofibromatosis 1
2007:External resources
1856:Nerve sheath tumor
1798:Hemangiopericytoma
710:Neurologic Clinics
548:European Radiology
457:Spinal cord tumors
373:histological grade
94:Signs and symptoms
2048:
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1930:
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1869:Neurofibromatosis
1824:
1823:
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1613:Oligodendroglioma
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1478:Craniopharyngioma
1331:(9486): 643–648.
1071:978-3-540-44714-6
959:(12): 1018–1024.
466:978-3-319-99438-3
271:neurological exam
253:hemangioblastomas
217:hemangioblastomas
156:hemangioblastomas
144:genetic syndromes
64:Von-Hippel Lindau
2068:
1934:
1921:brain metastasis
1885:Acoustic neuroma
1687:Oligoastrocytoma
1680:Multiple/unknown
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339:corticosteroids
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197:arachnoid mater
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166:Pathophysiology
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1937:Classification
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1730:Retinoblastoma
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1721:Ganglioneuroma
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1651:Choroid plexus
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1413:External links
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1378:(5): 631–640.
1372:Neuro-Oncology
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1131:
1096:(3): 320–328.
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842:
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716:(1): 241–268.
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1847:
1845:
1842:
1841:
1840:
1839:Neuroblastoma
1837:
1836:
1834:
1831:
1827:
1817:
1814:
1813:
1811:
1809:
1808:Hematopoietic
1805:
1799:
1796:
1794:
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1772:
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1756:
1752:
1746:
1743:
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1738:
1736:
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1728:
1726:
1725:Ganglioglioma
1722:
1719:
1718:
1716:
1714:
1708:
1698:
1695:
1693:
1690:
1688:
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1670:
1667:
1665:
1662:
1661:
1660:
1657:
1656:
1654:
1652:
1648:
1642:
1641:Subependymoma
1639:
1637:
1634:
1633:
1631:
1629:
1625:
1619:
1616:
1614:
1611:
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1537:
1536:spinal tumors
1532:
1527:
1523:
1520:
1518:
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1005:
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982:
978:
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966:
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958:
954:
953:Der Radiologe
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362:Observation,
357:
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348:
346:
344:
340:
336:
328:
326:
324:
323:Bone scanning
320:
316:
312:
308:
304:
300:
296:
292:
284:
282:
280:
276:
275:radiculopathy
272:
263:
258:
256:
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236:
234:
233:neurofibromas
230:
226:
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202:
198:
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190:
185:
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177:
173:
165:
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149:
148:Neurofibromas
145:
137:
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133:
129:
124:
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118:
114:
110:
106:
102:
93:
91:
89:
83:
81:
77:
73:
69:
65:
61:
57:
51:
49:
45:
41:
37:
33:
29:
25:
21:
20:Spinal tumors
2025:
2014:
1990:
1979:
1964:
1949:
1918:
1876:Neurilemmoma
1864:Neurofibroma
1593:Glioblastoma
1535:
1531:brain tumors
1493:
1465:
1375:
1371:
1361:
1328:
1324:
1317:
1303:
1292:
1283:
1250:
1246:
1236:
1199:
1195:
1185:
1144:
1140:
1134:
1093:
1089:
1049:
1003:
1000:ISRN Surgery
999:
989:
956:
952:
946:
916:(1): 103–8.
913:
909:
903:
860:
856:
810:
806:
766:(2): 262–6.
763:
759:
713:
709:
689:. Retrieved
686:www.aans.org
685:
633:, retrieved
621:
551:
547:
526:, retrieved
514:
456:
388:chemotherapy
377:
368:radiotherapy
364:chemotherapy
361:
352:
332:
288:
267:
249:osteosarcoma
237:
213:astrocytomas
205:
169:
141:
125:
105:sensory loss
97:
84:
80:astrocytomas
52:
19:
18:
2032:orthoped/49
2016:MedlinePlus
1735:Neurocytoma
1697:Gliosarcoma
1563:Astrocytoma
1483:Pituicytoma
315:T2-weighted
311:T1-weighted
303:myelography
229:schwannomas
221:meningiomas
209:ependymomas
172:spinal cord
152:schwannomas
76:ependymomas
68:meningiomas
62:(NF2), and
32:spinal cord
1992:DiseasesDB
1880:Schwannoma
1793:Meningioma
1636:Ependymoma
1325:The Lancet
1006:: 719715.
691:2019-12-03
635:2019-12-03
622:StatPearls
528:2019-12-03
515:StatPearls
475:1084270205
398:References
307:bone scans
279:myelopathy
193:dura mater
88:palliative
40:metastatic
36:dura mater
2039:radio/169
2027:eMedicine
1555:Astrocyte
1503:Pinealoma
1456:Endocrine
1161:1473-7175
1110:1534-6293
865:CiteSeerX
815:CiteSeerX
730:0733-8619
568:1432-1084
483:cite book
384:radiation
329:Treatment
269:complete
259:Diagnosis
201:pia mater
160:lymphomas
132:bone scan
128:Back pain
121:scoliosis
109:paralysis
24:neoplasms
2055:Category
2035:med/2993
1785:Meninges
1628:Ependyma
1402:22505658
1345:16112300
1267:29452284
1228:22629489
1177:32071879
1169:16274340
1126:14866999
1118:21327734
1056:. 2007.
1032:22084772
973:22198141
938:40059786
930:22156794
895:25396373
887:22547256
837:19429929
788:11919425
780:22099075
738:23186903
630:28722908
576:10460357
523:28723060
335:Steroids
189:meninges
1986:D013120
1393:3337309
1353:7761862
1275:3834414
1247:Spine J
1219:3356987
1023:3200210
981:2875418
584:6586168
349:Surgery
301:(MRI),
285:Imaging
58:(NF1),
48:bladder
30:or the
2021:001403
1713:neuron
1710:Mature
1546:Glioma
1494:Other:
1467:Sellar
1400:
1390:
1351:
1343:
1273:
1265:
1226:
1216:
1202:: 52.
1175:
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728:
628:
582:
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566:
521:
473:
463:
366:, and
337:(e.g.
305:, and
297:(CT),
291:X-rays
227:(e.g.
215:, and
199:, and
138:Causes
44:muscle
1997:31483
1975:192.2
1960:C72.0
1901:Other
1349:S2CID
1271:S2CID
1173:S2CID
1122:S2CID
1054:(PDF)
977:S2CID
934:S2CID
891:S2CID
784:S2CID
580:S2CID
392:spine
113:Bowel
1981:MeSH
1970:9-CM
1398:PMID
1341:PMID
1263:PMID
1224:PMID
1165:PMID
1157:ISSN
1114:PMID
1106:ISSN
1066:ISBN
1028:PMID
1004:2011
969:PMID
926:PMID
883:PMID
833:PMID
776:PMID
734:PMID
726:ISSN
626:PMID
572:PMID
564:ISSN
519:PMID
493:link
489:link
471:OCLC
461:ISBN
382:and
313:and
223:and
170:The
78:and
70:and
22:are
1966:ICD
1951:ICD
1830:PNS
1517:CNS
1388:PMC
1380:doi
1333:doi
1329:366
1255:doi
1214:PMC
1204:doi
1149:doi
1098:doi
1058:doi
1018:PMC
1008:doi
961:doi
918:doi
875:doi
825:doi
768:doi
718:doi
556:doi
386:or
277:or
115:or
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