Pediatric high-grade astrocytoma with piloid features of the spinal cord: A report of two cases and literature review

Although the 2021 World Health Organization classification update of the central nervous system tumors redefined "pilomyxoid astrocytoma" as high-grade astrocytoma with piloid features (HGAP), the craniocerebral HGAP exhibits poorer clinical outcomes when compared to pilocytic astrocytoma. However, in the spinal cord, the paucity of information of HGAP cases inhibits the judgment of prognosis and optimal management approaches for patients with spinal HGAP. Here, we summarized the clinical characteristics, management methods, and prognosis of ten cases of spinal HGAP reported in the literature and two cases of spinal HGAP who underwent tumor surgery in our institution. Here, the detailed clinical information we provided may help clinical decision-making for such rare childhood lesions. This study was approved by the Human Research Ethics Committees in our institution on June 29, 2021.