Desmoplastic infantile astrocytoma with multiple intracranial and intraspinal localizations at presentation.
OBJECTIVE
Desmoplastic infantile gliomas (DIG) are rare tumors that occur in infants aged between 1 and 24 months. The tumor in general has a favorable prognosis after surgical resection. There are no treatment algorithms, however, for patients with multiple intracranial and intraspinal presentations.


METHODS
In an 11-month-old girl with a history of nystagmus, magnetic resonance imaging (MRI) demonstrated contrast-enhancing lesions in the suprasellar region, the cerebellar vermis, and the spinal axis. The tumor in the cerebellar vermis was removed via a suboccipital midline approach. The histological examination revealed a desmoplastic infantile astrocytoma (DIA) WHO grade I. Postoperatively, it was decided to adopt a wait-and-see strategy. Further development, up to 16 months after surgery, was unremarkable. Follow-up MRI showed no recurrence of the posterior fossa tumor, mild progress of the suprasellar tumor, and significant regression of the spinal tumors.


CONCLUSIONS
DIA is a rare mostly benign brain tumor found in infants. The final diagnosis always relies on histology. Surgical resection is the recommended therapy for symptomatic tumors; however, more experience is needed to develop treatment recommendations for multiple-site tumors.
Department of Neurosurgery, Hannover Medical School, Carl-Neuberg Street. Nr. 1, 30625, Hannover, Germany.
Ghassan
G
Abuharbid
Majid
M
Esmaeilzadeh
Christian
C
Hartmann
Elvis J
EJ
Hermann
Joachim K
JK
Krauss
D001254:Astrocytoma / Q000175:diagnosis / Q000628:therapy*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000628:therapy*