Intracranial metastases from malignant spinal-cord astrocytoma. Case report

A patient with postoperative intracranial seeding from a malignant spinal-cord astrocytoma is presented. This case is compared with 17 previously cited cases of intracranial dissemination from spinal-cord astrocytoma. Factors associated with tumor dissemination include histological malignancy, proximity of the tumor to cerebrospinal fluid (CSF) pathways, and surgical manipulation. Hydrocephalus with infiltration of the basal cisterns also appears to be a consistent feature in these patients. Cytological studies of the CSF in this and previous cases were noted to be misleading, whereas intravenous contrast-enhanced cranial computerized tomography was invaluable for diagnosis of tumor dissemination in each case. Prophylactic irradiation of the entire neuraxis may limit intracranial metastases from malignant astrocytomas of the spinal cord.