Purpose or Case Report: Leptomeningeal dissemination (LD) is a common occurrence in primary central nervous system tumours. The most common tumours that develop LD are medulloblastoma, germ cell tumours, and glial tumours. However, in gliomas, this occurrence is rare. It has been reported that only 2-5% of children with low-grade gliomas present with LD. Retrospective review of the Pediatric Brain Tumour Study Group database revealed 4 cases of gliomas with leptomeningeal enhancement at initial presentation: 2 cases of pilocytic astrocytoma, 1 case of glioblastoma multiform in the cervical spinal cord and 1 case of diffuse intrinsic pontine glioma. The presence of LD at initial presentation of gliomas usually indicates poor prognosis, even in cases of pilocytic astrocytoma. Therapeutics also become a chalenge in face of such a rare and diffuse finding. Differential diagnosis should be made imaging wise with possible infectious/inflammatory process giving LD and focal lesions simulating tumors. Identification of LD at initial diagnosis is of major importance for treatment options and prognostication of gliomas in children.
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