• Adikarige H D Silva, Andrew R Stevens, Jooly Joseph, and Erminia Albanese.
• Department of Neurosurgery, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, UK.
• World Neurosurg. 2019 Aug 1; 128: 230-233.

BackgroundPilocytic astrocytoma is a benign glial tumor typically presenting in children. It is rare for adults to present with pilocytic astrocytoma and even less likely to manifest with multiple foci of lesions especially in nonoptic or hypothalamic locations.Case DescriptionOur patient was a 37-year old man presenting with varied cranial neuropathies, cerebellar dysfunction, and long tract signs, with imaging demonstrating 3 discrete ill-defined contrast-enhancing lesions affecting the cerebellar peduncles, brainstem, and cervicomedullary junction. Neuronavigation-guided biopsy confirmed World Health Organization grade 1 pilocytic astrocytoma; the patient was treated with radiotherapy.ConclusionsTo our knowledge, we believe this is the first reported case with multifocal infratentorial pilocytic astrocytoma on presentation in an adult patient in the absence of a prior history of associated risk factors such as neurofibromatosis 1 or chemoradiotherapeutic intervention.Copyright © 2019 Elsevier Inc. All rights reserved.

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