Recurrent spinal cord astrocytoma with intraventricular seeding.
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.
Peraud
A
A
Department of Neurosurgery, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany.
Herms
J
J
Schlegel
J
J
Müller
P
P
Kretzschmar
H
H
Tonn
J-C
JC
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