title: Recurrent spinal cord astrocytoma with intraventricular seeding.
abstract: METHODS
  We report on an unusual case of a recurrent and progressive spinal pilocytic astrocytoma with metastatic spreading to the hypothalamus in a 14-year-old boy.
  
  
  RESULTS
  The patient underwent resection of an intramedullary atypical pilocytic astrocytoma classified as WHO grade II at the level of Th11/12 in 1997 and received local photon beam irradiation. Three years later, a second operation was necessary for a recurrent tumour at the same level. Seventeen months later, a second recurrent tumour with spinal seeding as well as an intracranial tumour in the third ventricle and hypothalamus was detected. He was shunted for an occlusive hydrocephalus and a stereotactic biopsy of the hypothalamic lesion was performed. The tumour was classified as anaplastic pilocytic astrocytoma (WHO grade III). He received chemotherapy with ifosfamide, cisplatin and etoposide (HIT-GBM-C-protocol), craniospinal radiation, and is still alive 60 months after the first operative intervention without neurological deficits.
authors.affiliation: Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Peraud
authors.forename: J
authors.initials: J
authors.lastname: Herms
authors.forename: J
authors.initials: J
authors.lastname: Schlegel
authors.forename: P
authors.initials: P
authors.lastname: Müller
authors.forename: H
authors.initials: H
authors.lastname: Kretzschmar
authors.forename: J-C
authors.initials: JC
authors.lastname: Tonn
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000150:complications* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D001921:Brain / Q000473:pathology; D002551:Cerebral Ventricle Neoplasms / Q000209:etiology*; D003131:Combined Modality Therapy; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D013120:Spinal Cord Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D014057:Tomography, X-Ray Computed