{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:36:18Z","timestamp":1773786978877,"version":"3.50.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>H3K27M-mutant diffuse midline glioma is a recently classified unique entity predominantly affecting pediatric patients and rarely adults. The clinicopathologic features in adults remain poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>A 36-year-old man presented with subacute progressive cognitive and visual deterioration, and hydrocephalus requiring ventricular shunting. MRI revealed a diffusely infiltrating lesion with a gliomatosis cerebri growth pattern, multiple foci of contrast enhancement, and diffuse leptomeningeal involvement. Suboccipital craniotomy with exploration of the posterior fossa revealed a subtle capsular lesion infiltrating into the choroid plexus. Although histologically low-grade, the tumor was found to have an H3K27 M mutation establishing the diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In spite of diverse clinicopathologic characteristics, H3K27M-mutant diffuse midline gliomas are incurable, WHO grade IV lesions with poor prognosis. We discuss our case in the context of a review of published reports of H3K27-mutant diffuse midline gliomas in adults. Findings late in the disease course may mimic inflammatory or infectious pathologies radiographically, and low-grade infiltrative neoplasms histologically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The diverse clinical, radiographic and molecular features of H3K27M-mutant diffuse midline gliomas in adults remain to be completely characterized. A high index of suspicion is required to avoid missing the diagnosis. Early biopsy and detailed molecular characterization are critical for accurate diagnosis and patient counseling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.02.046","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T23:07:35Z","timestamp":1582931255000},"page":"124-128","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Adult H3K27M-mutant diffuse midline glioma with gliomatosis cerebri growth pattern"],"prefix":"10.1097","volume":"68","author":[{"given":"Anudeep","family":"Yekula","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihir","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Coley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoi Sang","family":"U","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-28-20260114","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12957-016-0820-x","article-title":"Clinical, radiological, and pathological features of 33 adult unilateral thalamic gliomas","volume":"14","author":"Zhang","year":"2016","journal-title":"World J. Surg. Oncol"},{"key":"R2-28-20260114","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s00412-015-0510-4","article-title":"Histone H3 mutations--a special role for H3.3 in tumorigenesis?","volume":"124","author":"Kallappagoudar","year":"2015","journal-title":"Chromosoma"},{"key":"R3-28-20260114","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1038\/nature10833","article-title":"Driver mutations in histone H3.3 and chromatin remodelling genes in paediatric glioblastoma","volume":"482","author":"Schwartzentruber","year":"2012","journal-title":"Nature"},{"key":"R4-28-20260114","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1038\/ng.1102","article-title":"Somatic histone H3 alterations in pediatric diffuse intrinsic pontine gliomas and non-brainstem glioblastomas","volume":"44","author":"Wu","year":"2012","journal-title":"Nat. Genet"},{"key":"R5-28-20260114","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/nan.12329","article-title":"K27M mutation in H3F3A in ganglioglioma grade I with spontaneous malignant transformation extends the histopathological spectrum of the histone H3 oncogenic pathway","volume":"43","author":"Joyon","year":"2017","journal-title":"Neuropathol. Appl. Neurobiol"},{"key":"R6-28-20260114","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/bpa.12336","article-title":"Diffuse midline gliomas with histone H3-K27M mutation: a series of 47 cases assessing the spectrum of morphologic variation and associated genetic alterations","volume":"26","author":"Solomon","year":"2016","journal-title":"Brain Pathol"},{"key":"R7-28-20260114","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/bpa.12473","article-title":"Co-occurrence of histone H3 K27M and BRAF V600E mutations in paediatric midline grade I ganglioglioma","volume":"28","author":"Pag\u00e8s","year":"2018","journal-title":"Brain Pathol"},{"key":"R8-28-20260114","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1309\/AJCPABOHBC33FVMO","article-title":"H3F3A K27M mutation in pediatric CNS tumors: a marker for diffuse high-grade astrocytomas","volume":"139","author":"Gielen","year":"2013","journal-title":"Am. J. Clin. Pathol"},{"key":"R10-28-20260114","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.ccr.2012.08.024","article-title":"Hotspot mutations in H3F3A and IDH1 define distinct epigenetic and biological subgroups of glioblastoma","volume":"22","author":"Sturm","year":"2012","journal-title":"Cancer Cell"},{"key":"R11-28-20260114","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s00401-014-1319-6","article-title":"Histopathological spectrum of paediatric diffuse intrinsic pontine glioma: diagnostic and therapeutic implications","volume":"128","author":"Buczkowicz","year":"2014","journal-title":"Acta Neuropathol"},{"key":"R12-28-20260114","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1309\/AJCPABOHBC33FVMO","article-title":"H3F3A K27M mutation in pediatric CNS tumors","volume":"139","author":"Gielen","year":"2013","journal-title":"Am. J. Clin. Pathol"},{"key":"R13-28-20260114","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/neuonc\/not144","article-title":"H3F3A K27M mutations in thalamic gliomas from young adult patients","volume":"16","author":"Aihara","year":"2014","journal-title":"Neuro-Oncology"},{"key":"R14-28-20260114","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1016\/j.humpath.2015.07.002","article-title":"The H3.3 K27M mutation results in a poorer prognosis in brainstem gliomas than thalamic gliomas in adults","volume":"46","author":"Feng","year":"2015","journal-title":"Hum. Pathol"},{"key":"R15-28-20260114","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s00401-015-1454-8","article-title":"Adult IDH wild type astrocytomas biologically and clinically resolve into other tumor entities","volume":"130","author":"Reuss","year":"2015","journal-title":"Acta Neuropathol"},{"key":"R16-28-20260114","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s00432-018-02836-5","article-title":"High frequency of H3 K27M mutations in adult midline gliomas","volume":"145","author":"Ebrahimi","year":"2019","journal-title":"J. Cancer Res. Clin. Oncol"},{"key":"R17-28-20260114","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s11060-019-03134-x","article-title":"Incidence and clinicopathologic features of H3 K27M mutations in adults with radiographically-determined midline gliomas","volume":"143","author":"Schreck","year":"2019","journal-title":"J. Neuro-Oncol"},{"key":"R18-28-20260114","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00401-015-1463-7","article-title":"High frequency of H3F3A (K27M) mutations characterizes pediatric and adult high-grade gliomas of the spinal cord","volume":"130","author":"Gessi","year":"2015","journal-title":"Acta Neuropathol"},{"key":"R19-28-20260114","doi-asserted-by":"crossref","first-page":"e1169","DOI":"10.1016\/j.wneu.2019.03.061","article-title":"Clinical and molecular characteristics of thalamic gliomas: retrospective report of 26 cases","volume":"126","author":"Liu","year":"2019","journal-title":"World Neurosurg"},{"key":"R20-28-20260114","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1093\/jnen\/nly006","article-title":"Adult brainstem gliomas with H3K27M mutation: radiology, pathology, and prognosis","volume":"77","author":"Daoud","year":"2018","journal-title":"J. Neuropathol. Exp. Neurol"},{"key":"R21-28-20260114","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1093\/neuonc\/now274","article-title":"Characteristics of H3 K27M-mutant gliomas in adults","volume":"19","author":"Meyronet","year":"2017","journal-title":"Neuro-Oncology"},{"key":"R22-28-20260114","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.humpath.2018.04.015","article-title":"H3 K27M\u2013mutant diffuse midline gliomas in different anatomical locations","volume":"78","author":"Wang","year":"2018","journal-title":"Hum. Pathol"},{"key":"R23-28-20260114","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5414\/NP301085","article-title":"H3 K27M-mutant gliomas in adults vs. children share similar histological features and adverse prognosis","volume":"37","author":"Kleinschmidt-DeMasters","year":"2018","journal-title":"Clin. Neuropathol"},{"key":"R24-28-20260114","first-page":"1049","article-title":"Diffuse midline glioma with an H3 K27M mutation: a comparison integrating the clinical, radiological, molecular features between adult and pediatric patients","volume":"21","author":"Jiang","year":"2019","journal-title":"Neuro-Oncology"},{"key":"R25-28-20260114","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s11060-013-1312-2","article-title":"Molecular analysis of diffuse intrinsic brainstem gliomas in adults","volume":"116","author":"Reyes-Botero","year":"2014","journal-title":"J. Neurooncol"},{"key":"R26-28-20260114","doi-asserted-by":"crossref","first-page":"53","DOI":"10.2176\/nmc.oa.2019-0168","article-title":"Midline glioma in adults: clinicopathological, genetic, and epigenetic analysis","volume":"60","author":"Enomoto","year":"2020","journal-title":"Neurol. Med. Chir"},{"key":"R27-28-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R28-28-20260114","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00401-016-1545-1","article-title":"The 2016 World Health Organization classification of tumors of the central nervous system: a summary","volume":"131","author":"Louis","year":"2016","journal-title":"Acta Neuropathol"},{"key":"R29-28-20260114","doi-asserted-by":"crossref","first-page":"e1501354","DOI":"10.1126\/sciadv.1501354","article-title":"Mutations in chromatin machinery and pediatric high-grade glioma","volume":"2","author":"Lulla","year":"2016","journal-title":"Sci. Adv"},{"key":"R30-28-20260114","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s00401-015-1478-0","article-title":"Histone H3F3A and HIST1H3B K27M mutations define two subgroups of diffuse intrinsic pontine gliomas with different prognosis and phenotypes","volume":"130","author":"Castel","year":"2015","journal-title":"Acta Neuropathol"},{"key":"R31-28-20260114","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1126\/science.1232245","article-title":"Inhibition of PRC2 activity by a gain-of-function H3 mutation found in pediatric glioblastoma","volume":"340","author":"Lewis","year":"2013","journal-title":"Science"},{"key":"R32-28-20260114","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.4161\/cc.25625","article-title":"A lesson learned from the H3.3K27M mutation found in pediatric glioma","volume":"12","author":"Chan","year":"2013","journal-title":"Cell Cycle"},{"key":"R33-28-20260114","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s00401-012-0998-0","article-title":"K27M mutation in histone H3.3 defines clinically and biologically distinct subgroups of pediatric diffuse intrinsic pontine gliomas","volume":"124","author":"Khuong-Quang","year":"2012","journal-title":"Acta Neuropathol"},{"key":"R34-28-20260114","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/neuonc\/nox149","article-title":"Diffuse high-grade gliomas with H3 K27M mutations carry a dismal prognosis independent of tumor location","volume":"20","author":"Karremann","year":"2018","journal-title":"Neuro-Oncology"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220301206?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220301206?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.02.046","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:11:33Z","timestamp":1768396293000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.02.046"}},"subtitle":["Case report and review of the literature"],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":33,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.02.046","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}