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Neurological Rehabilitation

Spinal Pilocytic Astrocytoma in An Adult: A Case Report

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 7

    Poster Presenter(s)

  • DN

    David Nguyen, DO

    Resident
    University of New Mexico School of Medicine PM&R Program
    Albuquerque, New Mexico

    • Co-Author(s)

  • KS

    Katherine Schenkel, MD

    Resident Physician
    University of New Mexico School of Medicine PM&R Program
    Albuquerque, New Mexico

  • WG

    Wallace Gladden, Jr., MD

    Attending Physiatrist
    University of New Mexico
    Albuquerque, New Mexico

Disclosure(s):
David Nguyen, DO: No financial relationships to disclose
Case Diagnosis: This is a patient who sustained an SCI due to a rare adult spinal cord tumor.

Case Description or Program Description: Patient presented to acute hospital 01/2024 with low back pain and progressive lower extremity weakness/paresthesias for 5 months. Symptoms became acutely worse about 1 week prior with intermittent bladder/bowel dysfunction and saddle anesthesia. Found to have large spinal cord lesion at T11 and underwent a T10-12 laminectomy for excision. Post-operatively, she had persistent lower extremity weakness and neurogenic bladder/bowel. She was admitted to inpatient rehabilitation from 01/25/24 to 02/14/24. On admission, was T12 ASIA B and improved to T10 ASIA D at 3 month follow-up.

Setting: Inpatient rehabilitation hospital

Assessment/Results: MRI L-Spine showed a large enhancing cystic and solid intramedullary spinal cord lesion at T11 and T7 syrinx extending down to conus medullaris. Tumor was excised and sent to pathology which showed evidence of a WHO grade I pilocytic astrocytoma.

Discussion (relevance): Spinal pilocytic astrocytomas are the most common type of intramedullary spinal cord tumor in pediatric/adolescent patients. There are very few cases of spinal pilocytic astrocytomas in adults. They are typically localized to the cervical/thoracic region and associated with tumor cyst or syrinx. The overall survival rate is close to 70-80% for adult patients. Surgical resection for the adult population is recommended. The probability of recurrence is low but still warrants serial monitoring. Postoperative radiotherapy is usually not indicated for pilocytic astrocytomas that are not infiltrative.

Conclusions: Adult spinal pilocytic astrocytomas are rare and more common in the pediatric/adolescent population. Mainstay treatment is usually gross total resection. Non-traumatic spinal cord injury is possible from the intramedullary astrocytoma, from surgical resection, or a combination of both. Close follow-up with neurosurgery and PM&R physician is recommended. Most available data on spinal pilocytic astrocytomas are from pediatric studies. More literature is needed from the adult population to provide more clinical information.