Abstract
Patient
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.
Treatment and 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.
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Acknowledgments
Dr. Aurelia Peraud is currently working as a fellow at The Arthur and Sonia Labatt Brain Tumor Research Center of The Hospital for Sick Children in Toronto, Canada, supported by the Deutsche Forschungsgemeinschaft (Pe 758/2–1).
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Peraud, A., Herms, J., Schlegel, J. et al. Recurrent spinal cord astrocytoma with intraventricular seeding. Childs Nerv Syst 20, 114–118 (2004). https://doi.org/10.1007/s00381-003-0812-3
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DOI: https://doi.org/10.1007/s00381-003-0812-3