Shekhar Kumar Keshri and Satyendra Narayan Sinha
Pilocytic Astrocytoma (PA) is a low grade benign tumor that rarely spread along the neuraxis. In this report, we described our experience with cranial pilocytic astrocytoma in a 14-year-old child, who initially treated with near total decompression of tumor and kept on close follow up. Four and half years later, recurrence of primary tumor with obstructive hydrocephalus occurred for which he underwent ventriculo-peritoneal shunt followed by re-excision. This time during planning for adjuvant radiotherapy, screening MRI spine revealed spinal drop metastasis for which he was planned for Craniospinal Irradiation (CSI).