Turkish Neurosurgery
Approach to Primary Vertebral Tumors in the Light of the 2020 Updated World Health Organization Classification of Bone Tumors
Ilkay Tosun1, Sait Naderi2
1Umraniye Education and Research Hospital, pathology, istanbul,
2QBmed, Istanbul Brain and Spine Center, neurosurgery, istanbul,
DOI: 10.5137/1019-5149.JTN.36208-21.2

Aim:The spinal canal frequently harbors primary and secondary bone tumors. These tumors have specific localization, age range, and clinical and radiological manifestations, and their treatment requires a multidisciplinary approach. In most cases, a definitive diagnosis is made based on clinical, radiological, and histopathological findings. Material and Methods:In this study, we have discussed primary vertebral tumors in light of the 2020 Updated World Health Organization Classification of Soft Tissue and Bone Tumors. Results:Chondroblastoma and chondromyxoid fibroma has been classified in the benign category, while synovial chondromatosis has been moved from the benign category to the intermediate category. In the updated classification, grade I chondrosarcoma has been classified in the malignant category with grade II–III chondrosarcomas. Minor amendments have been made for osteosarcoma subtypes. Neoplasms of undetermined origin, such as aneurysmal cysts, simple bone cysts, fibrosis dysplasia, and osteofibrous dysplasia, have been classified as neoplastic lesions. Chordomas have been classified into “not otherwise stated,” poorly differentiated chordomas, and dedifferentiated chordomas. Ewing’s sarcomas have been classified in a separate section for undifferentiated, small, round cell sarcomas of the bone and soft tissue. In this section, three distinct subsets different from Ewing’s sarcoma have been discussed. CIC-rearranged sarcoma, BCOR-rearranged sarcoma, and round cell sarcomas with EWSR1 gene fusion with non-ETS family members. Conclusion:In this study, we have reviewed the new classifications and discussed their effect on decision making in spinal oncologic surgery.

Corresponding author : Ilkay Tosun