Conclusion
Misdiagnosis frequently occurs in children with spinal tumors who exhibit musculoskeletal symptoms, leading to delayed diagnosis. This subgroup of patients frequently exhibited less aggressive tumors, rarely developed metastases or required additional therapy beyond surgery and tended to have a higher 5-year survival. These findings suggest that less aggressive tumors can give rise to gradually developing skeletal abnormalities and musculoskeletal symptoms, without accompanying neurological or general symptoms, thereby leading to misdiagnosis.