title: Intramedullary pilomyxoid astrocytoma with intracerebral metastasis exhibiting oligoden-droglioma-like features.
abstract: Intramedullary glioma are rare and their biological behaviour can differ from their cerebral counterparts. Pilomyxoid astrocytoma (PMA, WHO grade II), predominantly occur in the hypothalamic/chiasmatic region of infants and children. The few reported cases of pediatric intramedullary PMA displayed a particularly aggressive behavior. Here, we report a diagnostically challenging case of a five year old female patient presenting with intramedullary glioma and local tumor recurrence three years later. Twelve years after the initial manifestation, a second tumor was found intracerebrally. We performed a comprehensive histological, molecular pathological and imaging analysis of the tumors from both localizations. The results revealed a metastasizing PMA with unique histological and genetic features. Our study indicates that PMA comprise a heterogeneous group including aggressive subtypes which may not be compatible with the current classification according to WHO grade II. Furthermore, the case emphasizes the increasing relevance of molecular pathological markers complementing classic histo-logical diagnosis.
authors: Center for Neuropathology.
authors: Sabina
authors: S
authors: Eigenbrod
authors: Niklas
authors: N
authors: Thon
authors: Nathalie
authors: N
authors: Jansen
authors: Hendrik
authors: H
authors: Janssen
authors: Janina
authors: J
authors: Mielke
authors: Michael
authors: M
authors: Ruiter
authors: Christian
authors: C
authors: la Fougère
authors: Aurelia
authors: A
authors: Peraud
authors: Rupert
authors: R
authors: Egensperger
authors: Hans
authors: H
authors: Kretzschmar