disseminated juvenile pilomyxoid astrocytoma of the hypothalamic-chiasmatic region

Pilomyxoid astrocytoma (pma) is a recently described histological type of pilocytic astrocytoma (pa), but the tumors show histological differences. pma has more aggressive malignant behavior than pa. magnetic resonance imaging (mri) may play a crucial role in the preoperative setting and also help to establish an appropriate therapeutic regimen. in this case report, we illustrated mri findings of a hypothalamic-chiasmatic pma in a 15-year-old female patient presenting with extensive leptomeningeal seeding. the patient was operated for total tumor resection, but could not survive the second post-operative day. we have comprehensively discussed the clinical, imaging, and histopathological features of these relatively rare tumors and also reviewed the recent literature.