Asymptomatic leptomeningeal dissemination of tumor to the spinal cord: Report of three cases

Three children with a history of malignant tumor (cerebellar medulloblastoma in two cases and adrenal neuroblastoma in one case) are discussed. All three had diffuse leptomeningeal dissemination, which was confirmed at autopsy. Computed tomography (CT) revealed diffuse enhancement of the intracranial subarachnoid spaces after the administration of contrast material. Despite the absence of spinal cord signs and symptoms, autopsy showed severe diffuse seeding of neoplastic cells in the spinal subarachnoid space giving the spinal cord the appearance of a 'bamboo stick'. Myelography is necessary to disclose clinically silent spinal cord lesions when CT or cerebrospinal fluid cytological examination reveals evidence of subarachnoid dissemination of tumor.