title: Multicentric anaplastic astrocytoma in a child.
abstract: We report a rare case of anaplastic astrocytoma with multicentric central nervous system lesions in a 10-year-old girl presenting with a 1-month history of progressive headache and paraparesis. Neurological examination upon admission revealed papilloedema of both eyes and grade 2/5 weakness of both legs. Cranial and spinal magnetic resonance imaging revealed multiple tumour foci within the suprasellar region, cerebellar hemisphere, cervical and thoracic cords. After an uneventful laminectomy and excision of the tumour at the T8-9 level, a significant improvement of motor function was observed. The histological diagnosis was anaplastic astrocytoma based on the WHO classification. The patient received postoperative radiotherapy and chemotherapy, and was able to walk with the aid of auxiliary crutches. Despite being an uncommon disease in children and being associated with an unfavourable long-term outcome, early diagnosis and appropriate management of this condition may contribute to reduced patient morbidity.
authors.affiliation: Division of Neurology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Chaiyos
authors.initials: C
authors.lastname: Khongkhatithum
authors.forename: Anannit
authors.initials: A
authors.lastname: Visudtibhan
authors.forename: Surang
authors.initials: S
authors.lastname: Chiemchanya
authors.forename: Pongsakdi
authors.initials: P
authors.lastname: Visudhiphan
authors.forename: Prasert
authors.initials: P
authors.lastname: Sanvivad
authors.forename: Noppadol
authors.initials: N
authors.lastname: Larbcharoensub
authors.forename: Suchart
authors.initials: S
authors.lastname: Phudhicharoenrat
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013904:Thoracic Vertebrae; D016896:Treatment Outcome