SciELO - Scientific Electronic Library Online

vol.22 issue5Ectopic relapse of an operated craniopharyngioma: Case report and review of the literatureMeduloblastoma: infrequent onset in local recurrence author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google



Print version ISSN 1130-1473


JUSUE-TORRES, I. et al. Leptomeningeal spread of an intramedullary cervical pilocytic astrocytoma: case report and literature review. Neurocirugía [online]. 2011, vol.22, n.5, pp.445-452. ISSN 1130-1473.

Background. The rarest location of pilocytic astrocytoma is intramedullary. Gliomas represent up to 24-30% of intramedullary tumors in adulthood and are second only after ependymomas. Leptomeningeal dissemination through cerebrospinal fluid is unusual and occurs predominantly in medulloblastomas, ependymoblastomas, central neuroblastomas, ependymomas, germ cell tumors and high-grade gliomas. The majority of spinal cord gliomas reporting metastasis were anaplastic astrocytomas or glioblastomas multiforme and relatively few were low-grade gliomas. The incidence of leptomeningeal spread of low-grade tumors is rare. A rare cranial extension of brain leptomeningeal dissemination in an intramedullary pilocytic astrocytoma during adulthood is reported. Case report. A 51 year-old-man with a recurrent intramedullary mass at C5-C7 level operated 4 times with all pathological anatomy reports describing the lesion as Pilocytic Astrocytoma developed, after 15 years from the diagnosis, visual hallucinations and his level of consciousness worsened to Glasgow coma score 13/15. The MRI showed highly enhanced cranial and spinal leptomeninges and paquimeninges with a micro-nodular-granulomatous aspect associated with intense affectation of basal cisterns, subarachnoid spaces and convexity of both cerebral hemispheres suggestive of leptomeningeal spread of the spinal mass. The patient expired after three days. Conclusion. Leptomeningeal spread is a rare phenomenon and when it happens usually doesn't change the primary tumor's behavior. In our case the aggressivenes could be explained by a potential malignization of the primary tumor that it wasn't documented because of the partial resectionss from the lasts surgeries or instead the tumor was actually a monomorphous pilomyxoid tumor.

Keywords : Intramedullary spinal tumor; Leptomeningeal dissemination; Low-grade glioma; Pilocytic astrocytoma.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License