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We present a unique pediatric case with this rare complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report:<\/jats:title>\n                    <jats:p>A 5-month-old female infant, born after a complicated pregnancy, presented with rapidly progressive intracranial pressure. Imaging revealed a large, hemorrhagic, left parieto-occipital lesion with osteolysis and subsequent transcalvarial herniation. Intraoperatively, a culture-negative abscess was found within the tumor. Initial biopsy suggested a low-grade glioma, but final histopathology confirmed a high-grade glioma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>The combination of a giant, abscessed, and osteolytic HGG leading to transcalvarial herniation in a young infant is unprecedented. Intratumoral abscesses in pediatric HGGs are not previously documented, making this case a significant addition to the literature. The sterile abscess may be linked to tumor necrosis or the patient's perinatal history. This atypical presentation underscores the diverse nature of pediatric HGGs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This first reported case of a giant, hemorrhagic, osteolytic, and abscessed pediatric HGG with transcalvarial herniation highlights an exceptionally rare and aggressive presentation in a very young infant. It emphasizes the need for considering unusual features in pediatric brain tumors and warrants further investigation into the pathogenesis and management of such complex lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111748","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T06:56:02Z","timestamp":1754549762000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Giant hemorrhagic and abscessed pediatric high-grade glioma with osteolysis and transcalvarial herniation: A unique presentation and literature review"],"prefix":"10.1097","volume":"135","author":[{"given":"Mehdi","family":"Borni","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marouen","family":"Taallah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brahim","family":"Kammoun","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatem","family":"Daoud","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houda","family":"Belmabrouk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mohamed Ben Sassi University Hospital, Gabes, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Zaher","family":"Boudawara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"Suppl","key":"R1-3-20260803","doi-asserted-by":"crossref","first-page":"x1","DOI":"10.1093\/neuonc\/nou327","article-title":"Alex's lemonade stand foundation infant and childhood primary brain and central nervous system tumors diagnosed in the United States in 2007-2011","volume":"16","author":"Ostrom","year":"2015","journal-title":"Neuro Oncol"},{"issue":"12","key":"R2-3-20260803","doi-asserted-by":"crossref","first-page":"iii1","DOI":"10.1093\/neuonc\/noab200","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018","volume":"23","author":"Ostrom","year":"2021","journal-title":"Neuro-oncology"},{"key":"R3-3-20260803","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.ccell.2017.08.017","article-title":"Integrated molecular Meta-analysis of 1000 pediatric high-grade and diffuse intrinsic pontine glioma","volume":"32","author":"Mackay","year":"2017","journal-title":"Cancer Cell"},{"key":"R4-3-20260803","doi-asserted-by":"crossref","first-page":"6099","DOI":"10.3390\/cancers13236099","article-title":"Childhood malignant brain tumors: balancing the bench and bedside","volume":"13","author":"Thorbinson","year":"2021","journal-title":"Cancers"},{"key":"R5-3-20260803","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1097\/WCO.0000000000000871","article-title":"Beyond the World Health Organization classification of central nervous system tumors 2016: what are the new developments for gliomas from a clinician's perspective?","volume":"33","author":"Weller","year":"2020","journal-title":"Curr. 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