NCMP-15. A CASE OF SYSTEMIC METASTATIC DIFFUSE LEPTOMENINGEAL GLIONEURAL TUMOR

Abstract INTRODUCTION Diffuse leptomeningeal glioneural tumor (DLGT) is a very rare central nervous that has no standard of care for its treatment. This report illustrates case DLGT with unique presentation and first description multiple systemic metastasis. Case: 19 year-old male personal history hereditary osteochondromas recent covid-19 infection who on investigation headaches, progressive cranio-neuropathies, right-sided weakness was found to have vasospasms resulting in acute infarcts vascular areas, diffuse enhancement the thoracic spine cauda equina. Patient underwent meningeal biopsy, after 2 months symptoms, which revealed per two different neuro-oncology centers. Course disease complicated hydrocephalus needing shunt placement soon diagnosis. Craniospinal radiation concurrent temozolomide started one month from developed pancytopenia chemotherapy stop weeks during therapy. Metastatic bone marrow diagnosed second adjuvant cycle through biopsy. One week after, pleural effusion, lung metastasis were discovered cytology computer tomography. Liquid biopsy showed non-actionable mutations PIK3CA, BRAF KRAS. Chemotherapy carboplatin vincristine markedly improvement effusions leading cessation frequent transfusions auxiliary oxygen. Vincristine dose decreased due painful neuropathy tinnitus. At end endovenous chemotherapy, worsening muscles face brain parenchyma. then enrolled hospice, dying after. CONCLUSION should be considered differential diagnosis vasospasm. primary system can metastasize other organs. Although yet identified, offered metastatic disease.