Introduction

Pilocytic astrocytoma is a low-grade glioma more frequently seen in patients <20. It is pretty uncommon in the spinal cord. Rarely, astrocytoma may involve the most or total length of the spinal cord; in that case, they are called “holo-cord astrocytoma.” In this case report, we are reporting the third holo-cord pilocytic astrocytoma in an adult patient and the first with an extension to the Magendie foramen.

Case presentation

We presented a 24-year-old woman with complaints of progressively worsening neck and back pain since one year ago. The patient’s MRI showed a very large intradural and intramedullary cystic lesion with a solid component within the spinal cord extending from the medulla to the conus medullaris. Partial resection of the solid part of the cervical portion of the tumor was performed. Histopathological evaluation of the resected tumor segments was compatible with grade I pilocytic astrocytoma. After one year of follow-up, neck and back pain has reduced, and neurological functions have improved.

Conclusion

Spinal cord pilocytic astrocytoma may present as a holo-cord tumor and can rarely extend to the intracranial fossa. Although this tumor does not arise from the central canal, in this case, it was extended through the Magendie foramen. Symptoms could be subtle despite extensive cord involvement. On MRI, this tumor presents as an intramedullary holo-cord cystic lesion intermixed with a solid component with a variable enhancement of the solid component.

中文翻译：

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年轻女性颅内扩展的全息毛细胞星形细胞瘤：病例报告和 MRI 特征回顾

 介绍

毛细胞星形细胞瘤是一种低级别胶质瘤，常见于<20岁的患者。这在脊髓中相当罕见。极少数情况下，星形细胞瘤可能累及脊髓的大部分或全部长度；在这种情况下，它们被称为“全索星形细胞瘤”。在本病例报告中，我们报告了一名成年患者的第三例全索毛细胞星形细胞瘤，以及第一例延伸至马让迪孔的星形细胞瘤。

 案例展示

我们向一位 24 岁的女性介绍了自一年前以来颈部和背部疼痛逐渐恶化的症状。患者的 MRI 显示非常大的硬膜内和髓内囊性病变，脊髓内有实性成分，从髓质延伸到髓圆锥。对肿瘤颈部的实体部分进行部分切除。切除肿瘤部分的组织病理学评估与 I 级毛细胞星形细胞瘤相符。随访一年后，颈背疼痛减轻，神经功能改善。

 结论

脊髓毛细胞星形细胞瘤可能表现为全脊髓肿瘤，很少会扩散到颅内窝。尽管该肿瘤并非源自中央管，但在本例中，它已延伸至 Magendie 孔。尽管脊髓广泛受累，但症状可能很微妙。在 MRI 上，该肿瘤表现为髓内全索囊性病变，与实性成分混合，且实性成分有不同程度的增强。