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Spinal Cord Diffuse Midline Glioma in a 4-Year-Old Boy.
Child Neurol Open 2019; 6:2329048X19842451CN

Abstract

Objective

We report a child presenting with spinal myelopathy secondary to H3K27M mutant diffuse midline glioma.

Case Report

A 4-year-old boy presented with a 3-week history of progressive gait difficulty. Examination revealed bilateral hand and lower extremity weakness, left leg hypertonia with ankle clonus, and a right hemisensory deficit. Magnetic resonance imaging of neuroaxis showed cervical and thoracic spinal cord with expansion and irregular areas of enhancement. Serum and cerebrospinal fluid studies were unremarkable for infectious, autoimmune, inflammatory, and neoplastic causes but showed mild cerebrospinal fluid pleocytosis, hypoglycorrhachia, and high protein level. A thoracic cord biopsy revealed a diffuse midline glioma (World Health Organization grade IV). Consequently, the tumor involved intracranial structures and patient died within 4 months after diagnosis.

Conclusion

High-grade spinal cord gliomas are very rare but should be considered in the differential diagnosis of pediatric myelopathy. Tissue biopsy is recommended in indeterminate cases to facilitate diagnosis and to guide management.

Authors+Show Affiliations

Division of Pediatric Neurology, University of Alabama, Birmingham, AL, USA. School of Medicine, University of Alabama, Birmingham, AL, USA. Division of Pediatric Neurology, Penn State Milton S. Hershey Medical Center, Pennsylvania, PA, USA.Division of Pediatric Neurology, University of Alabama, Birmingham, AL, USA. School of Medicine, University of Alabama, Birmingham, AL, USA.Division of Pediatric Radiology, Children's Hospital of Alabama, Birmingham, AL, USA.Division of Pediatric Pathology, University of Alabama, Birmingham, AL, USA.Division of Pediatric Neurology, University of Alabama, Birmingham, AL, USA. School of Medicine, University of Alabama, Birmingham, AL, USA.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31065566

Citation

Kumar, Ashutosh, et al. "Spinal Cord Diffuse Midline Glioma in a 4-Year-Old Boy." Child Neurology Open, vol. 6, 2019, p. 2329048X19842451.
Kumar A, Rashid S, Singh S, et al. Spinal Cord Diffuse Midline Glioma in a 4-Year-Old Boy. Child Neurol Open. 2019;6:2329048X19842451.
Kumar, A., Rashid, S., Singh, S., Li, R., & Dure, L. S. (2019). Spinal Cord Diffuse Midline Glioma in a 4-Year-Old Boy. Child Neurology Open, 6, p. 2329048X19842451. doi:10.1177/2329048X19842451.
Kumar A, et al. Spinal Cord Diffuse Midline Glioma in a 4-Year-Old Boy. Child Neurol Open. 2019;6:2329048X19842451. PubMed PMID: 31065566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal Cord Diffuse Midline Glioma in a 4-Year-Old Boy. AU - Kumar,Ashutosh, AU - Rashid,Salman, AU - Singh,Sumit, AU - Li,Rong, AU - Dure,Leon S, Y1 - 2019/04/28/ PY - 2019/02/26/received PY - 2019/03/14/accepted PY - 2019/5/9/entrez PY - 2019/5/9/pubmed PY - 2019/5/9/medline KW - H3K27M mutation KW - diffuse midline glioma KW - glioblastoma KW - pediatrics KW - spinal cord disorders SP - 2329048X19842451 EP - 2329048X19842451 JF - Child neurology open JO - Child Neurol Open VL - 6 N2 - Objective: We report a child presenting with spinal myelopathy secondary to H3K27M mutant diffuse midline glioma. Case Report: A 4-year-old boy presented with a 3-week history of progressive gait difficulty. Examination revealed bilateral hand and lower extremity weakness, left leg hypertonia with ankle clonus, and a right hemisensory deficit. Magnetic resonance imaging of neuroaxis showed cervical and thoracic spinal cord with expansion and irregular areas of enhancement. Serum and cerebrospinal fluid studies were unremarkable for infectious, autoimmune, inflammatory, and neoplastic causes but showed mild cerebrospinal fluid pleocytosis, hypoglycorrhachia, and high protein level. A thoracic cord biopsy revealed a diffuse midline glioma (World Health Organization grade IV). Consequently, the tumor involved intracranial structures and patient died within 4 months after diagnosis. Conclusion: High-grade spinal cord gliomas are very rare but should be considered in the differential diagnosis of pediatric myelopathy. Tissue biopsy is recommended in indeterminate cases to facilitate diagnosis and to guide management. SN - 2329-048X UR - https://www.unboundmedicine.com/medline/citation/31065566/Spinal_Cord_Diffuse_Midline_Glioma_in_a_4-Year-Old_Boy L2 - http://journals.sagepub.com/doi/full/10.1177/2329048X19842451?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -