Okuda Tomohiro, Hata Nobuhiro, Suzuki Satoshi O, Yoshimoto Koji, Arimura Koichi, Amemiya Takeo, Akagi Yojiro, Kuga Daisuke, Oba Utako, Koga Yuhki, Ohga Shouichi, Iwaki Toru, Iihara Koji
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Neuropathology. 2018 Apr 19. doi: 10.1111/neup.12471.
The 2016 edition of the World Health Organization Classification of Tumors of the Central Nervous System introduced "diffuse midline glioma H3 K27M mutant" as a new diagnostic entity. These tumors predominately affect pediatric patients and arise from midline structures such as the brainstem, thalamus and spinal cord. Here, we report a rare patient with spinal ganglioglioma carrying an H3 K27M mutation. A 10-year-old boy presented with an intramedullary tumor in the cervical spinal cord. The lesion was partially removed and histologically diagnosed as ganglioglioma. After the remnant tumor grew within 3 months after surgery, the patient underwent radiotherapy. Genetic analyses revealed an H3F3A K27M mutation but no other genetic alterations such as IDH and BRAF mutations. This case may point to pathological heterogeneity in gliomas with H3 K27M mutations.
2016年版世界卫生组织中枢神经系统肿瘤分类引入了“弥漫性中线胶质瘤H3 K27M突变型”这一新的诊断实体。这些肿瘤主要影响儿童患者,起源于脑干、丘脑和脊髓等中线结构。在此,我们报告1例携带H3 K27M突变的罕见脊髓节细胞胶质瘤患者。一名10岁男孩表现为颈髓髓内肿瘤。病变部分切除,组织学诊断为节细胞胶质瘤。术后3个月残余肿瘤生长,患者接受了放疗。基因分析显示存在H3F3A K27M突变,但未发现其他基因改变,如异柠檬酸脱氢酶(IDH)和BRAF突变。该病例可能提示H3 K27M突变型胶质瘤存在病理异质性。