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Case Reports
. 2023 Jun 20;82(7):659-663.
doi: 10.1093/jnen/nlad032.

An unusual case of metastatic diffuse midline glioma in an adult

Maria A Gubbiotti  1 , Kiratpreet Singh Dhillon  2 , Jaryse Harris  1 , Shawn Kothari  3 , Jeffrey B Ware  4 , Arati Desai  3 , Jacob Shabason  3 , Markku Miettinen  5 , Martha Quezado  5 , Kenneth Aldape  5 , Kevin Judy  6 , Zi-Xuan Wang  2 , Mark T Curtis  2 , MacLean P Nasrallah  1
Affiliations
Case Reports

An unusual case of metastatic diffuse midline glioma in an adult

Maria A Gubbiotti et al. J Neuropathol Exp Neurol. .
No abstract available

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Conflict of interest statement

The authors have no duality or conflicts of interest to declare.

Figures

Figure 1
Figure 1
(A) MRI at initial presentation showing a 2 × 1 cm nonenhancing T2/FLAIR hyperintense lesion in the posteromedial left temporal lobe and thalamus; (B) follow-up MRI 3 months later showing mild increase in size and expansion of the component in the posteromedial left temporal lobe (yellow arrow) and new subtle leptomeningeal enhancement along the ventral surface of the brainstem (red arrows); (C) MRI an additional month later showing marked progression of leptomeningeal enhancement in the supratentorial compartment; (D) spine MRI showing leptomeningeal enhancement encasing the spinal cord (yellow arrow).
Figure 2
Figure 2
(A–C) H&E images of the temporal lobe biopsy in region of meningeal enhancement depicting tumor cells localized to the subarachnoid space. (D) Synaptophysin stain highlights a few tumor cells.
Figure 3
Figure 3
(A) CT showing widespread patchy sclerosis throughout the spine and sternum, corresponding to diffuse hypointensity on T1-weighted MRI consistent with diffuse marrow replacement. (B) H&E of bone depicting metastatic glioma (inset demonstrating cytology at higher power). (C, D) GFAP and H3K27M immunostains highlighting metastatic glial cells.
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