Spinal diffuse midline glioma: An unusual case presentation

Abstract

Primary spinal cord neoplasms are rare, accounting for 1% of paediatric central nervous system tumours. The majority of which are low-grade gliomas (LGG). A teenage male presented with rapidly progressive lower limb paralysis. He subsequently underwent a near-total resection of an intramedullary thoracic tumour. Although the initial histopathology report suggested a LGG, closer review of the morphology and immunohistochemical staining revealed a diffusely infiltrating high-grade astrocytoma. Methylation profiling later confirmed a H3K27M-mutated spinal DMG. He underwent spinal radiation to the tumour bed soon after surgery but succumbed to his disease 8 days after completing radiation, and 3 months after presentation. Conclusion: Spinal DMGs are rare, can lead to diagnostic challenges and have a poor prognosis.

Keywords

• midline cns tumours
• diffuse midline glioma
• high-grade gliomas
• spinal h3k27m-altered dmg
• methylation profiling
• imrt