Spinal oligodendroglioma with gliomatosis in a child - Case report

The authors present a rare case of oligodendrogliomatosis in a child, which they believe originated from a primary spinal cord tumor. At 2.5 years of age this boy developed poor balance, neck stiffness, and a regression in de velopmental milestones. A computerized tomography (CT) scan of the head ini tially revealed ventriculomegaly and multiple cystic cerebellar lesions. In addition, magnetic resonance (MR) imaging revealed a cystic intramedullary lesion involving the cervical spinal cord. A CT scan of the head and an MR image obtained 3 years later demonstrated diffuse small cysts on the surfa ce of the brainstem, cerebellum medial temporal and inferior frontal cortic es, subcortical white matter, and corpus callosum suggestive of leptomening eal tumor spread. Analysis of pathological specimens obtained at surgery sh owed neoplastic glial cells with small, uniform nuclei and perinuclear clea r zones. The cells appeared to migrate along the subpial space but no tumor cells were present in the subarachnoid space. These findings were compatib le with a diagnosis of oligodendrogliomatosis cerebri. Despite having a com plicated course, chemotherapy with carboplatin has provided the patient wit h long-term palliation and a high quality of life. This case may represent the fifth report in the literature of oligodendrogliomatosis occurring in a child but only the third occurring with a spinal primary tumor.