Preschooler with left leg weakness and back pain

MRI of diffuse leptomeningeal glioneuronal tumor
Sagittal T1 MRI without contrast of the spine (above left) shows a focal protruberant intramedullary mass in the spinal cord at C7 and T1 that is hyperintense on sagittal T2 MRI (above center) and that on the sagittal T1 MRI with contrast (above right) enhances minimally. There is also thick leptomeningeal enhancement anterior and posterior to the cervical spine. The sagittal T1 MRI with contrast of the brain (below) shows thick leptomeningeal enhancement of the brain, particularly around the basal cisterns.

The diagnosis was diffuse leptomeningeal glioneuronal tumor.