Recurrent cerebellar liponeurocytoma with multifocal leptomeningeal dissemination

Cerebellar liponeurocytoma (cLNC) is a rare World Health Organization Grade 2 glioneuronal tumor, generally considered indolent. Leptomeningeal dissemination is exceptionally uncommon. A 68-year-old woman underwent surgical resection of a posterior fossa cLNC. Two years later, she developed multifocal leptomeningeal lesions in the optochiasmatic cistern and left pontomedullary angle. She underwent three posterior fossa resections followed by whole-brain radiotherapy. Post-operative central adrenal insufficiency required endocrine management. At the last follow-up, there was no evidence of recurrence. Despite its histologically low-grade nature, cLNC can behave aggressively, and vigilant craniospinal follow-up with multidisciplinary management is essential.