Unexpected discovery of a diffuse astrocytoma of the conus medullaris in an elderly NF1 patient

• Main Authors: Takamistu Uchi, MD, Tsutomu Inaoka, MD, PhD, Noriko Kitamura, MD, PhD, Rumiko Ishikawa, MD, PhD, Tomoya Nakatsuka, MD, PhD, Shusuke Kasuya, MD, Wataru Tokuyama, MD, PhD, Nobuyuki Hiruta, MD, PhD, Hiroshi Takahashi, MD, PhD, Hitoshi Terada, MD, PhD
• Format: Article
• Language: English
• Published: Elsevier 2020-06-01
• Series: Radiology Case Reports
• Subjects: Diffuse astrocytoma; Spinal cord; Neurofibromatosis; Follow-up MRI; Biopsy
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320300741
• ISSN: 1930-0433

Neurofibromatosis type 1 (NF1) is one of the most common genetic neurocutaneous disorders, and it is well known to be associated with peripheral or central nervous system malignancies. The most common malignant tumors are malignant peripheral nerve sheath tumors (MPNSTs); MPNSTs are the most common cause of death in patients with NF1. Central nervous system malignancies rarely occur. So far, the occurrence of spinal cord malignancies is exceedingly rare. Herein, we report a rare case of a 69-year-old male with NF1 following tumor resection twice for cutaneous MPNSTs developing intramedullary diffuse astrocytoma in the conus medullaris, which initially presented with traumatic spinal cord injury associated with a compression fracture from fall. Contrast-enhanced magnetic resonance imaging and biopsy of the spinal cord were required to establish the final diagnosis.