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Case Reports
. 2023 Jan 12;15(1):1-5.
doi: 10.1159/000528311. eCollection 2023 Jan-Dec.

Flank Pain as a First Symptom of a Diffuse Midline Glioma

Burc Bassa  1 , Achim Battmann  2 , Eva Maria Craemer  1 , Uta Meyding-Lamadé  1
Affiliations
Case Reports

Flank Pain as a First Symptom of a Diffuse Midline Glioma

Burc Bassa et al. Case Rep Neurol. .

Abstract

Diffuse midline gliomas are a new entity in the WHO Classification of Tumors of the Central Nervous System, corresponding to grade 4 gliomas. The diagnostic pathognomonic feature is the presence of a H3K27M mutation. Although mainly seen in children, cases in adults have also been reported. The symptoms are highly variable and usually dependent on the location and extent of spinal cord compression.

Keywords: Acute paraparesis; K27M mutation; Midline glioma; Spinal cord tumors.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Fig. 1.
Fig. 1.
a Axial contrast-enhanced T1 image, showing a contrast-enhancing lesion in the left cingulate gyrus. b T2-weighted axial image. c Sagittal contrast-enhanced T1 image.
Fig. 2.
Fig. 2.
a Sagittal T2 image of a tumor ranging from Th7 to Th12, significantly compressing the spinal cord ventrally. b Axial T2 image of nodular tumor manifestation at conus medullaris and filum terminale.
Fig. 3.
Fig. 3.
Histological and immunohistochemical examination of a biopsy specimen of the nodular lesion on the filum terminale. a H&E staining showing infiltrating and nodular proliferation of pleomorphic cells with hyperchromatic nuclei and scant cytoplasm. b H&E staining, higher magnification. c KI-67 staining, a nuclear protein that is associated with cellular proliferation. d Specimen with S-100 staining.
See this image and copyright information in PMC

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