Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adult

H3 K27-Altered Diffuse Midline Gliomas are commonly found in children and adolescents in midline locations such as the thalamus, brain stem, and spinal cord. It is rare for these tumors to affect adults and to occur in locations like the lateral ventricles. Despite aggressive treatment methodologies...

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Main Authors: Merari Jasso, Jay-Jiguang Zhu, Meenakshi B. Bhattacharjee, Georgene W. Hergenroeder
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1477978/full
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author Merari Jasso
Jay-Jiguang Zhu
Meenakshi B. Bhattacharjee
Georgene W. Hergenroeder
author_facet Merari Jasso
Jay-Jiguang Zhu
Meenakshi B. Bhattacharjee
Georgene W. Hergenroeder
author_sort Merari Jasso
collection DOAJ
description H3 K27-Altered Diffuse Midline Gliomas are commonly found in children and adolescents in midline locations such as the thalamus, brain stem, and spinal cord. It is rare for these tumors to affect adults and to occur in locations like the lateral ventricles. Despite aggressive treatment methodologies, there is no cure for this disease. The median survival is between 8-12 months. A 24-year-old white male presented to the emergency department due to severe headache refractory to pain medications with a 2-month history of progressive headaches and eventual memory problems. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an intraventricular enhancing mass and hydrocephalus. The final diagnosis was an intraventricular H3 K27-Altered Diffuse Midline Glioma. The patient underwent two craniotomies, one laser interstitial thermal ablation (LITT), chemoradiotherapy, and bevacizumab and ONC206, through compassionate use. Despite a reduction in the tumor size, it continued to spread to other brain areas, leading to further complications and, eventually, his death, 10 months after initial diagnosis. From review of the literature, 21 cases were identified, and the median age was 24. Their median survival is 10.5 months (ranges 1 - 24 months). This case report presents the clinical, radiological, pathological, and molecular characteristics of a 24-year-old white man diagnosed with a ventricular H3 K27-Altered diffuse midline glioma, highlighting the rare presentation, management, and outcomes.
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spelling doaj-art-fbf4e352e04a4fcda3583c4b505620f32025-08-20T02:50:45ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-03-011510.3389/fonc.2025.14779781477978Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adultMerari Jasso0Jay-Jiguang Zhu1Meenakshi B. Bhattacharjee2Georgene W. Hergenroeder3The Vivian L. Smith Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United StatesThe Vivian L. Smith Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United StatesDepartment of Pathology & Laboratory Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United StatesThe Vivian L. Smith Department of Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United StatesH3 K27-Altered Diffuse Midline Gliomas are commonly found in children and adolescents in midline locations such as the thalamus, brain stem, and spinal cord. It is rare for these tumors to affect adults and to occur in locations like the lateral ventricles. Despite aggressive treatment methodologies, there is no cure for this disease. The median survival is between 8-12 months. A 24-year-old white male presented to the emergency department due to severe headache refractory to pain medications with a 2-month history of progressive headaches and eventual memory problems. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an intraventricular enhancing mass and hydrocephalus. The final diagnosis was an intraventricular H3 K27-Altered Diffuse Midline Glioma. The patient underwent two craniotomies, one laser interstitial thermal ablation (LITT), chemoradiotherapy, and bevacizumab and ONC206, through compassionate use. Despite a reduction in the tumor size, it continued to spread to other brain areas, leading to further complications and, eventually, his death, 10 months after initial diagnosis. From review of the literature, 21 cases were identified, and the median age was 24. Their median survival is 10.5 months (ranges 1 - 24 months). This case report presents the clinical, radiological, pathological, and molecular characteristics of a 24-year-old white man diagnosed with a ventricular H3 K27-Altered diffuse midline glioma, highlighting the rare presentation, management, and outcomes.https://www.frontiersin.org/articles/10.3389/fonc.2025.1477978/fulldiffuse midline glioma (DMG)diffuse midline glioma H3 K27-alteredadult DMGH3 K27H3K27M mutation
spellingShingle Merari Jasso
Jay-Jiguang Zhu
Meenakshi B. Bhattacharjee
Georgene W. Hergenroeder
Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adult
Frontiers in Oncology
diffuse midline glioma (DMG)
diffuse midline glioma H3 K27-altered
adult DMG
H3 K27
H3K27M mutation
title Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adult
title_full Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adult
title_fullStr Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adult
title_full_unstemmed Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adult
title_short Case Report: Rare intraventricular H3 K27-altered diffuse midline glioma in an adult
title_sort case report rare intraventricular h3 k27 altered diffuse midline glioma in an adult
topic diffuse midline glioma (DMG)
diffuse midline glioma H3 K27-altered
adult DMG
H3 K27
H3K27M mutation
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1477978/full
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