HOME > Weekly Case > Weekly Case
Weekly Case
종결
Case No. 715
2025-03-01~2025-03-31
출제자 : 이지영
Hit : 480
| Period | 2025-03-01~2025-03-31 |
|---|---|
| Diagnosis | Diffuse Midline Glioma with H3K27-altered |
| Gender |
|
| Age | 37 |
| Clinical information | M/37 c/c: Visual field defect (bitemporal hemianopsia) for 1 year Initially treated as pituitary macroadenoma with hormone tx (cabergoline) . worsened visual disturbance |
| Discussion | -Diffuse glioma with H3 K27M or H3 K27I mutation -High-grade infiltrative glioma with predominantly astrocytic differentiation (WHO Grade IV) -Mostly in children, but can occur in adults -Poor prognosis -Location: Midline or paramedian Brainstem (pons m/c), Thalamus (2nd), Spinal cord, Hypothalamus… -Pathology Fusiform enlargement of pons Mostly astrocytic differentiation with focal necrosis, hemorrhage, microvascular proliferation -Brainstem Type: Diffuse infiltration of pons with indistinct margins Often expands anteriorly, engulfing basilar artery T1WI: Hypointense T2WI/FLAIR: Hyperintense Contrast: No or little patchy enhancement -Thalamic Type: Enlarged thalamus T2/FLAIR: Hyperintense Variable enhancement, but usually minimal or patchy (<25%) -Metastatic Pattern: Leptomeningeal dissemination and "brain-to-brain" metastases common in all types |
| Correct answer |
Correct AnswerSemi-Correct Answer |