not-yet-known not-yet-known not-yet-known unknown Methods (differential diagnosis, investigations and treatment) Preoperative imaging, specifically magnetic resonance imaging (MRI) of the spine, showed a lesion with heterogeneous high signal intensity on T2-weighted sequences and isointensity on T1-weighted sequences, extending from the T9 to T12 vertebrae, as shown in Figure 1. A subsequent surgical intervention involved a meticulous total microsurgical excision of the lesion. During the procedure, the tumor was observed adhering to both the spinal cord and the pia mater at the location of the previous surgery. Postoperative spinal MRI indicated successful tumor debulking of the lower spinal cord, noting changes from the operation and residual tumor presence. In November 2021, the patient experienced a notable improvement and was discharged with plans for routine follow-up visits every few months. Five months post-discharge, while the lesion showed no significant alterations, the patient reported numbness in the abdominal area. Physical examination revealed heightened reflexes in the right lower limb. Histopathological analysis of the samples confirmed the presence of astrocytoma, with additional testing identifying AGAP1:NTRK2 fusion via fluorescence in situ hybridization (FISH). Based on these findings, it was determined to continue monitoring the patient both clinically and radiologically.