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  • Case Report
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Holocord pilocytic astrocytoma in a young woman with intracranial extension: case report and review of the MRI characteristics



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.


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.

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Fig. 1: Whole spine MRI of holocord pilocytic astrocytoma.
Fig. 2: MRI of holocord pilocytic astrocytoma.
Fig. 3: Histopathological evaluation of the tumor.

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Data availability

Data sharing does not apply to this article as no datasets were generated or analyzed during the current study. The corresponding author makes the MRI and pathology images and reports available on reasonable request.


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The authors would like to thank K. Eghbal M.D. at the Neurosurgery department of Shiraz University of Medical Sciences who put a lot of effort into the operation and follow-up of the patient.


The authors received no financial support for the research, authorship, and/or publication of this article.

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SKS was responsible for literature search, data acquisition, manuscript preparation, manuscript writing, editing, and manuscript review and approved the final version. AD was responsible for material preparation, manuscript preparation, manuscript writing, editing, and manuscript review and approved the final version. AT was responsible for material preparation, manuscript preparation, manuscript writing, editing, and manuscript review and approved the final version. AD was responsible for concept, design, data acquisition, manuscript preparation, manuscript writing, editing, and manuscript review and approved the final version.

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Correspondence to Alireza Dehghan.

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This study was approved by the Institutional Ethics Committee (IR.SUMS.MED.REC.1401.154). Written informed consent was obtained from the subject described in the publication.

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Kiani Salmi, S., Dehghanian, A., Taherifard, A. et al. Holocord pilocytic astrocytoma in a young woman with intracranial extension: case report and review of the MRI characteristics. Spinal Cord Ser Cases 10, 43 (2024).

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