Malignant Spinal Tumors

Pediatric malignant spinal tumors are rare but aggressive cancers that originate within or around the spinal cord, vertebrae, or spinal nerves in children. Unlike benign tumors, these malignant neoplasms have a high potential for local invasion, neurological damage, and metastasis. Early diagnosis and prompt multidisciplinary management are crucial for survival and quality of life. In Bangladesh, many cases of pediatric spinal cancer are either misdiagnosed, referred late, or inadequately managed due to the shortage of specialized pediatric neurosurgical services and oncology resources. Under the expert care of Dr. Md. Nafaur Rahman, patients now have access to world-class spinal tumor care at NINS and Bangladesh Paediatric Neurocare Centre, with integrated support from neuro-oncology and rehabilitation teams. Common Types of Malignant Spinal Tumors in Children Malignant spinal tumors in children can arise from different anatomical compartments: 1. Primary Intramedullary Tumors (inside the spinal cord): High-grade astrocytomas Ependymomas (anaplastic subtype) 2. Extradural/Vertebral Tumors (from bone or surrounding tissue): Ewing’s Sarcoma – The most common malignant bone tumor in the spine Osteosarcoma – May affect vertebral bodies Chordomas – Rare tumors at the sacrum or skull base Lymphoma or Leukemic Infiltration – Especially in immunocompromised children 3. Metastatic Spinal Tumors: Spread from neuroblastoma, leukemia, or Wilms’ tumor These tumors often present late, and due to the spine's confined space, they can cause rapid neurological deterioration. Warning Signs & Symptoms Malignant spinal tumors often present subtly, mimicking benign conditions. Warning symptoms include: Persistent or severe back pain, often worse at night Sudden-onset limb weakness or paralysis Changes in walking pattern, unsteady gait Loss of bladder or bowel control Spinal deformity or scoliosis Systemic signs like weight loss, fever, or fatigue Palpable spinal or paraspinal mass In Bangladesh, these signs are frequently misinterpreted as orthopedic issues, delaying neurosurgical referral and reducing survival chances. Diagnostic Protocol At Dr. Nafaur Rahman’s centers, children with suspected spinal tumors undergo a rapid and structured diagnostic evaluation: MRI of the entire spine with contrast – Detects tumor size, location, cord compression CT Scan of the Spine – For bone involvement Spinal and bone marrow biopsy – For histopathological confirmation PET-CT or bone scan – To evaluate metastasis CSF cytology – For tumors involving the spinal leptomeninges Blood tests & tumor markers – Including LDH, AFP, and NSE Genetic & immunohistochemistry studies – Especially in Ewing’s sarcoma and lymphoma Fast-track diagnostics at NINS and BP Neurocare Centre minimize delay and allow early treatment initiation. Surgical Management Surgery plays a key role in diagnosis, decompression, and tumor control, even in malignant cases. Dr. Md. Nafaur Rahman leads a skilled neurosurgical team trained in microsurgical spinal tumor removal with modern intraoperative techniques. Surgical Goals: Decompression of spinal cord to prevent paralysis Maximal safe resection of tumor Tissue diagnosis (biopsy or excisional) Spinal stabilization or reconstruction, when vertebral bodies are involved Surgical Techniques: Laminectomy or laminoplasty Microsurgical tumor resection using high-powered operating microscope Intraoperative neuro-monitoring to protect spinal nerves Spinal instrumentation and fusion for stability after tumor removal Multidisciplinary collaboration with pediatric oncologists for intraoperative decision-making “In pediatric spinal oncology, surgery is not only about removing the tumor—it’s about preserving mobility, preventing deformity, and improving long-term survival.” — Dr. Md. Nafaur Rahman Oncological Treatment & Rehabilitation Following surgery, most children with malignant spinal tumors require multi-modality treatment to improve outcomes and prevent recurrence. Comprehensive Treatment Plan: Chemotherapy – Based on tumor type (e.g., Ewing’s sarcoma protocols) Radiotherapy – Conformal or proton therapy to reduce cord toxicity Targeted therapy and immunotherapy – In eligible cases Rehabilitation – Physical therapy, occupational therapy, neuro-rehabilitation Psychosocial support – Counseling for child and parents All adjuvant therapies are coordinated by a dedicated pediatric neuro-oncology team in collaboration with NINS and private cancer centers. Bangladesh Context: Unique Challenges and Solutions Managing pediatric malignant spinal tumors in Bangladesh poses several challenges: Common Issues: Low awareness among primary care and orthopedic doctors Financial barriers to MRI and histopathology **Lack of pediatric oncology support in remote areas Cultural stigma surrounding cancer diagnosis and spinal surgery Dr. Nafaur Rahman’s Commitment: Offers free consultation camps and early referral pathways Works to raise awareness among pediatricians, neurologists, and school health programs Leads interdisciplinary tumor boards for difficult cases Connects patients to financial aid and support organizations Why Trust Dr. Md. Nafaur Rahman? One of the leading pediatric neurosurgeons in Bangladesh Based at NINS, the country’s premier neurosurgical institute Expert in complex spinal tumor surgeries in children Utilizes intraoperative monitoring and advanced surgical tools Works closely with pediatric oncologists, pathologists, and rehab therapists Delivers evidence-based care with empathy and precision Contact for Pediatric Spinal Tumor Evaluation Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre For Serial/Appointment: 01912988182 | 01607033535 Website: www.neurosurgeonnafaur.com