• Madhivanan Karthigeyan, Pankaj Kumar, Pravin Salunke, Manish Rohilla, Debjyoti Chatterjee, and Chirag Kamal Ahuja.
• Department of Neurosurgery, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, India.
• World Neurosurg. 2021 Jan 1; 145: 443-447.

BackgroundPleomorphic xanthoastrocytoma (PXA), a relatively uncommon, World Health Organization grade II tumor of astrocytic origin, occurs in children and in general carries good prognosis. The recently identified anaplastic PXA (grade III) type shows poor outcome. Rarely, these said tumors can display an aggressive clinical course with features of leptomeningeal spread. Such cases are mostly seen in adults, with rare instances reported in the pediatric age group.Case DescriptionIn this report, we describe an 8-year-old child with anaplastic PXA with a rapid downhill course due to cerebrospinal fluid spread. This child is perhaps the first pediatric report in which the cerebrospinal fluid dissemination was established on cytology.ConclusionsThe case is an indicator of the need for craniospinal screening protocol in patients with PXA, especially the anaplastic variety, both at the time of initial diagnosis and follow-up.Copyright © 2020 Elsevier Inc. All rights reserved.

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