LETTER TO THE EDITOR Rosette-forming glioneuronal tumour of dorsolumbar spinal cord Sanjeev A. Sreenivasan 1 & Kanwaljeet Garg 1 & Aruna Nambirajan 2 & Vaishali Suri 2 & Manmohan Singh 1 & P. Sarat Chandra 1 Received: 15 April 2019 /Accepted: 7 May 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 A 14-year-old boy presented to our clinic with history of gradually progressive paraparesis for the last 10 years. The patient also had history of urinary incontinence and consti- pation. Both lower limbs were spastic (Ashworth grade3) on examination and motor power was 0/5 (MRC grade) in both lower limbs. His magnetic resonance image showed a contrast en- hancing lesion extending from D7-L1 (Figs.1 and 2). The lesion was ill-defined and compressing the spinal cord to the right (axial images, Fig. 3). The patient also had sco- liosis of the dorsolumbar spine (X-ray image, Fig. 4) with primary curve to the right and compensatory bend to the left. He underwent D6-L2 exploration and decompression of the tumour. Intraoperatively, a greyish white soft suckable moderately vascular tumour was identified with poor plane from the surrounding cord. The histopatholog- ical examination of the tumour revealed a rosette-forming glioneuronal tumour (RGNT). Microscopically, the tu- mour was composed of monomorphic and bland cells ar- ranged in repetitive small rosettes (Fig. 4). A 6-month follow-up of this patient showed marginal improvement in power to MRC grade 2  5 and reduction in spasticity (Ashworth grade 2). Cases of similar rosette-forming glioneuronal tumour have been reported involving the posterior fossa, pineal region, optic nerve, hypothalamus and cervical spinal cord. The posterior fossa tumour was composed of bland neurocytes arranged in rosettes along with glial areas re- sembling pilocytic astrocytoma. MIB-1 labelling index was reported < 1% [2, 5]. There was no necrosis, anapla- sia nor microvascular proliferation. The neurocytic rich region showed strong synaptophysin positivity. The sur- rounding glial tissue showed GFAP positivity. Till date, only one patient has been reported to harbour a dorsolumbar (D7-L1) RGNT. This 27-year-old female presented with paraplegia and bladder-bowel inconti- nence. Radiological evaluation showed a T1 hypointense and T2 hyperintense lesion with heterogenous contrast enhancement. Following a gross total excision of the le- sion, she has remained clinically stable at 15-month fol- low-up duration [4]. Discussion RGNT is a new pathological entity with only about 50 cases reported in literature. Female preponderance has been recorded and mean age is of around 31 years. A single case report of patient with NF1 harbouring RGNT in the optic nerve has been described. Radiological ap- pearance of RGNT comprises of T1 iso-to hypointense lesion and T2 hyperintense lesion with occasional pres- ence of calcification. This lesion usually appears well circumscribed and comprises solid and cystic areas on MR images. Rare satellite lesions have also been described. Only five cases of spinal RGNT have been reported till date. Pathologically, these lesions are soft, gelatinous well-circumscribed areas with minimal surrounding re- gion of infiltration. On microscopy, two separate compo- nents have been described [1]. The neurocytic portion has uniformly arranged rosettes of neurocytes and perivascular pseudorosettes. The glial component usually resembles pilocytic astrocytoma with spindle and piloid * Kanwaljeet Garg kanwaljeet84@gmail.com 1 Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India 2 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India Child's Nervous System https://doi.org/10.1007/s00381-019-04200-5