Intramedullary Spinal Cord Tumors in Pediatric Patients.

Intramedullary spinal cord tumors in children are rare but important lesions representing fewer than 10% of pediatric central nervous system tumors. Low-grade astrocytomas and ependymomas predominate, with modern molecular markers-such as MAPK pathway alterations, H3K27M mutations, and MYCN amplification-refining diagnosis and prognosis. Children often present with progressive pain, motor deficits, or scoliosis, leading to delayed recognition. MRI, including diffusion tensor imaging, is essential for evaluation and surgical planning. Maximal safe resection remains the cornerstone of management, with radiotherapy or chemotherapy reserved for selected cases. Despite potential morbidity, long-term survival and functional outcomes are favorable for many patients.