{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:29:18Z","timestamp":1787646558581,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>\n                    Diffuse midline glioma,\n                    <jats:italic toggle=\"yes\">H3 K27<\/jats:italic>\n                    -altered is a rare and aggressive pediatric brain tumor with a grim prognosis. Diffuse midline glioma is characterized by specific molecular alterations, including\n                    <jats:italic toggle=\"yes\">H3 K27<\/jats:italic>\n                    mutations, and involves deep midline structures such as the brainstem, cerebellum, spinal cord, and thalamus. These tumors present with a classic triad of symptoms and have limited surgical options due to their challenging locations. Extra-neural metastases are an unusual occurrence in diffuse midline glioma and have been rarely described. Here we report a 17-year-old girl with spinal diffuse midline glioma,\n                    <jats:italic toggle=\"yes\">H3 K27M-mutant,<\/jats:italic>\n                    who presented with multiple metastatic osseous lesions confirmed on biopsy of the thoracic vertebral lesion. Due to the rapid disease progression, the patient was recommended palliative therapy. Extra-neural metastases in diffuse midline glioma are rare, with only 16 reported patients, and no standard therapy exists. An accurate and early diagnosis is necessary to develop a personalized plan of treatment. Further research is needed to gain insights into the molecular pathology of diffuse midline glioma,\n                    <jats:italic toggle=\"yes\">H3 K27<\/jats:italic>\n                    -altered, and improve the quality of life and the outcome of patients with this deadly disease.\n                  <\/jats:p>","DOI":"10.1177\/10668969241286243","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T03:32:00Z","timestamp":1728358320000},"page":"907-915","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Spinal Diffuse Midline Glioma\n                    <i>H3 K27M<\/i>\n                    -Altered: Report of a Rare Tumor with Extracranial Skeletal Metastases and Review of Literature"],"prefix":"10.1177","volume":"33","author":[{"given":"Aditi","family":"Rathi","sequence":"first","affiliation":[{"name":"Department of Pathology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit Kumar","family":"Choudhari","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3574-8855","authenticated-orcid":false,"given":"Ayushi","family":"Sahay","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kajari","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpita","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameya D","family":"Puranik","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4340-5548","authenticated-orcid":false,"given":"Aekta","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archya","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejpal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1038-5755","authenticated-orcid":false,"given":"Sridhar","family":"Epari","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab106"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/bpa.12336"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2017.08.017"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.9308"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-020-02142-w"},{"issue":"1","key":"e_1_3_2_7_2","first-page":"1","article-title":"Bone metastases in an adult patient with diffuse midline glioma: a case report","volume":"3","author":"Li S","year":"2021","unstructured":"Li S, Lai M, Zhen J, et al. Bone metastases in an adult patient with diffuse midline glioma: a case report. 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