title: Leptomeningeal dissemination of pilocytic astrocytoma via hematoma in a child. Case report.
abstract: A case of recurrent pilocytic astrocytoma with leptomeningeal dissemination (LMD) is described. A cerebellar tumor was diagnosed in a 3-year-old boy, in whom resection was performed. When the boy was 6 years of age, recurrence was treated with surgery and local radiotherapy. At age 13 years, scoliosis was present, but the patient was asymptomatic. Twelve years after initial surgery LMD was demonstrated in the lumbar spinal region without recurrence of the original tumor. This tumor also was subtotally removed. During the procedure, a hematoma was observed adjacent to the tumor, but the border was clear. Histological examination of the spinal cord tumor showed features similar to those of the original tumor. There were no tumor cells in the hematoma. The MIB-1 labeling index indicated no malignant change compared with the previous samples. Radiotherapy was performed after the surgery. The importance of early diagnosis and management of scoliosis is emphasized, and the peculiar pattern of dissemination of the pilocytic astrocytoma and its treatment are reviewed.
authors.affiliation: Department of Surgical Neurology, Jichi Medical School, Tochigi, Japan. kandada@jichi.ac.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Kanda
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Soji
authors.initials: S
authors.lastname: Shinoda
authors.forename: Toshio
authors.initials: T
authors.lastname: Masuzawa
mesh_terms: D001099:Arachnoid / Q000473:pathology; D001254:Astrocytoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002528:Cerebellar Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000150:complications*; D002675:Child, Preschool; D006406:Hematoma / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000556:secondary*; D009366:Neoplasm Seeding; D010841:Pia Mater / Q000473:pathology; D012600:Scoliosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed