Pilomyxoid astrocytoma of the spinal cord with cerebrospinal fluid and peritoneal metastasis

Pilomyxoid astrocytoma (PMA) is a recently described rare tumor which is a variant of pilocytic astrocytoma (PA). It exhibits a more aggressive behavior than PA. Spinal cord PMA has been reported in two articles in the past and none of the reported case had extraneural metastasis. We report on a female child with cervical cord PMA with diffuse leptomeningeal metastasis involving the brain and spinal cord. Two years later she presented with peritoneal carcinomatoses which was consistent with metastatic tumor via a ventriculoperitoneal (VP) shunt. This case confirms the aggressive behavior of PMA and makes clinicians aware of the possibility of extraneural, peritoneal metastasis through a VP shunt.