Diffuse cerebrospinal gliomatosis with extensive leptomeningeal spread

A case of diffuse cerebrospinal gliomatosis with extensive leptomeningeal s pread is presented. The patient, an 18-year-old girl, was admitted due to p rogressive weakness and paresthesia of both legs, following rapid neuropsyc hiatric deterioration. An initial magnetic resonance imaging (MRI) study of the T-spine showed diffuse high signal intensities from T9 to T12 spinal c ords on a T2 sagittal image and diffuse cord bulging at T1WI. This suggeste d an inflammatory lesion such as tuberculosis or fungal meningoencephalitis . A limited autopsy was performed. A microscopic examination revealed multi focal GFAP-positive astrocytic proliferations that were low grade astrocyto ma in the cerebral leptomeninges, parietal, occipital and temporal lobes an d anaplastic astrocytoma in the spinal cord and spinal leptomeninges. The h igh proliferative indices of the spinal lesion and aneuploidy correspond to a diagnosis of malignant astrocytoma and a rapid fatal clinical course.