DISSEMINATION OF LOW-GRADE INTRACRANIAL ASTROCYTOMAS IN CHILDREN

The authors report three cases of histologically benign intracranial a strocytomas that developed in children and disseminated within the neu raxis. Multicentric disease was evident at the time of diagnosis in tw o of these patients, one of whom subsequently developed peritoneal see ding of tumor after placement of a ventriculoperitoneal shunt. To our knowledge, this latter represents the first documented case of extrane ural seeding of a benign astrocytoma. All three children are currently alive and well 17-117 months after the diagnosis of tumor disseminati on. We review the literature regarding this uncommon problem and discu ss the pathophysiology and treatment options. Our results indicate tha t the presence of disseminated disease may not preclude long term surv ival, provided the lesions are truly benign histologically and that ad juvant therapy is instituted promptly.