{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:27:12Z","timestamp":1769725632231,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,7,14]]},"abstract":"\n BACKGROUND<\/jats:title>\n \n IDH<\/jats:italic>\n -mutant diffuse gliomas are considered low grade, albeit with a propensity for malignant behavior over time, distinguishing them from pediatric-type low-grade gliomas.\n IDH<\/jats:italic>\n -mutant tumors have astrocytic or oligodendrocytic phenotypes associated with\n TP53<\/jats:italic>\n and\n ATRX<\/jats:italic>\n mutations or\n 1p\/19q<\/jats:italic>\n deletions, respectively.\n TP53<\/jats:italic>\n mutations are associated with a tumor that acquires malignant properties characteristic of glioblastoma with subsequent very poor survival.\n <\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n \n The authors present the case of a 12-year-old female who presented with an incidental T2-FLAIR bright lesion in the right frontal lobe. Although clinically asymptomatic, there was interval minimal but definite growth on serial imaging over 5 years, and she underwent resection. Molecular pathology indicated an isolated\n IDH1<\/jats:italic>\n mutation, without cooperating molecular changes.\n <\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n \n IDH<\/jats:italic>\n -mutant gliomas, although typically an adult disease, may be diagnosed in childhood or adolescence. This early diagnosis of a tumor before it has acquired cooperating events suggests childhood origin and long latency for this more typical adult tumor. Early recognition and treatment of these tumors, before they reach their full malignant potential, may yield therapeutic benefit. Surgery may also play a key role to eliminate neoplastic cells and the acquisition of more fully malignant clones that may become more aggressive and drive disease progression many years later.\n <\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE2584<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case2584","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T06:25:48Z","timestamp":1752474348000},"source":"Crossref","is-referenced-by-count":0,"title":["A role for early surgical intervention in childhood low-grade glioma? Illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Youngkyung","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Dirks","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uri","family":"Tabori","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology, The Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7653-9529","authenticated-orcid":true,"given":"Anirban","family":"Das","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology, The Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Dirks","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1202-5881","authenticated-orcid":true,"given":"Jennifer L.","family":"Quon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"bib1","series-title":"Pediatr Blood Cancer","first-page":"1173","article-title":"Long-term outcome of 4,040 children diagnosed with pediatric low-grade gliomas: an analysis of the surveillance epidemiology and end results (SEER) database","volume":"61","author":"Bandopadhayay","year":"2014","unstructured":"Bandopadhayay PBergthold GLondon WBLong-term outcome of 4,040 children diagnosed with pediatric low-grade gliomas: an analysis of the surveillance epidemiology and end results (SEER) database. 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Target Oncol. 2020;15(4):531-540."},{"issue":"4","key":"bib4","series-title":"Cancer Cell","first-page":"569","article-title":"Integrated molecular and clinical analysis of 1,000 pediatric low-grade gliomas","volume":"37","author":"Ryall","year":"2020","unstructured":"Ryall SZapotocky MFukuoka KIntegrated molecular and clinical analysis of 1,000 pediatric low-grade gliomas. Cancer Cell. 2020;37(4):569-583.e5."},{"issue":"10","key":"bib5","series-title":"Childs Nerv Syst","first-page":"3179","article-title":"Incidental brain tumor findings in children: prevalence, natural history, management, controversies, challenges, and dilemmas","volume":"40","author":"Soleman","year":"2024","unstructured":"Soleman JConstantini SRoth J.Incidental brain tumor findings in children: prevalence, natural history, management, controversies, challenges, and dilemmas. Childs Nerv Syst. 2024;40(10):3179-3187."},{"issue":"5","key":"bib6","series-title":"Sci Adv","first-page":"eaaw4543","article-title":"Cancer-associated mutation and beyond: the emerging biology of isocitrate dehydrogenases in human disease","volume":"5","author":"Tommasini-Ghelfi","year":"2019","unstructured":"Tommasini-Ghelfi SMurnan KKouri FMMahajan ASMay JLStegh AH.Cancer-associated mutation and beyond: the emerging biology of isocitrate dehydrogenases in human disease. Sci Adv. 2019;5(5):eaaw4543."},{"issue":"4","key":"bib7","series-title":"Mol Diagn Ther","first-page":"457","article-title":"IDH inhibitors and beyond: the cornerstone of targeted glioma treatment","volume":"25","author":"Gatto","year":"2021","unstructured":"Gatto LFranceschi ETosoni AIDH inhibitors and beyond: the cornerstone of targeted glioma treatment. Mol Diagn Ther. 2021;25(4):457-473."},{"issue":"5","key":"bib8","series-title":"Cell Rep","first-page":"1267","article-title":"Low-grade astrocytoma mutations in IDH1, P53 and ATRX cooperate to block differentiation of human neural stem cells via repression of SOX2","volume":"21","author":"Modrek","year":"2017","unstructured":"Modrek ASGolub DKhan TLow-grade astrocytoma mutations in IDH1, P53 and ATRX cooperate to block differentiation of human neural stem cells via repression of SOX2. Cell Rep. 2017;21(5):1267-1280."},{"issue":"26","key":"bib9","series-title":"N Engl J Med","first-page":"2481","article-title":"Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas","volume":"372","author":"Cancer Genome Atlas Research Network","year":"2015","unstructured":"Cancer Genome Atlas Research NetworkBrat DJVerhaak RGWComprehensive, integrative genomic analysis of diffuse lower-grade gliomas. 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Am J Pathol. 2009;174(4):1149-1153."},{"issue":"4","key":"bib15","series-title":"Neuro Oncol","first-page":"462","article-title":"A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method","volume":"15","author":"Walker","year":"2013","unstructured":"Walker DALiu JKieran MA multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method. 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Am Soc Clin Oncol Educ Book. 2014;34:e436-e440."},{"issue":"4","key":"bib3","series-title":"Target Oncol","first-page":"531","article-title":"Clinical relevance of BRAF V600E mutation status in brain tumors with a focus on a novel management algorithm","volume":"15","author":"Kowalewski","year":"2020","unstructured":"Kowalewski ADur\u015blewicz JZdrenka MGrzanka DSzylberg \u0141.Clinical relevance of BRAF V600E mutation status in brain tumors with a focus on a novel management algorithm. Target Oncol. 2020;15(4):531-540."},{"issue":"4","key":"bib4","series-title":"Cancer Cell","first-page":"569","article-title":"Integrated molecular and clinical analysis of 1,000 pediatric low-grade gliomas","volume":"37","author":"Ryall","year":"2020","unstructured":"Ryall SZapotocky MFukuoka KIntegrated molecular and clinical analysis of 1,000 pediatric low-grade gliomas. Cancer Cell. 2020;37(4):569-583.e5."},{"issue":"10","key":"bib5","series-title":"Childs Nerv Syst","first-page":"3179","article-title":"Incidental brain tumor findings in children: prevalence, natural history, management, controversies, challenges, and dilemmas","volume":"40","author":"Soleman","year":"2024","unstructured":"Soleman JConstantini SRoth J.Incidental brain tumor findings in children: prevalence, natural history, management, controversies, challenges, and dilemmas. Childs Nerv Syst. 2024;40(10):3179-3187."},{"issue":"5","key":"bib6","series-title":"Sci Adv","first-page":"eaaw4543","article-title":"Cancer-associated mutation and beyond: the emerging biology of isocitrate dehydrogenases in human disease","volume":"5","author":"Tommasini-Ghelfi","year":"2019","unstructured":"Tommasini-Ghelfi SMurnan KKouri FMMahajan ASMay JLStegh AH.Cancer-associated mutation and beyond: the emerging biology of isocitrate dehydrogenases in human disease. Sci Adv. 2019;5(5):eaaw4543."},{"issue":"4","key":"bib7","series-title":"Mol Diagn Ther","first-page":"457","article-title":"IDH inhibitors and beyond: the cornerstone of targeted glioma treatment","volume":"25","author":"Gatto","year":"2021","unstructured":"Gatto LFranceschi ETosoni AIDH inhibitors and beyond: the cornerstone of targeted glioma treatment. Mol Diagn Ther. 2021;25(4):457-473."},{"issue":"5","key":"bib8","series-title":"Cell Rep","first-page":"1267","article-title":"Low-grade astrocytoma mutations in IDH1, P53 and ATRX cooperate to block differentiation of human neural stem cells via repression of SOX2","volume":"21","author":"Modrek","year":"2017","unstructured":"Modrek ASGolub DKhan TLow-grade astrocytoma mutations in IDH1, P53 and ATRX cooperate to block differentiation of human neural stem cells via repression of SOX2. Cell Rep. 2017;21(5):1267-1280."},{"issue":"26","key":"bib9","series-title":"N Engl J Med","first-page":"2481","article-title":"Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas","volume":"372","author":"Cancer Genome Atlas Research Network","year":"2015","unstructured":"Cancer Genome Atlas Research NetworkBrat DJVerhaak RGWComprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N Engl J Med. 2015;372(26):2481-2498."},{"issue":"7","key":"bib10","series-title":"Am J Pathol","first-page":"1820","article-title":"Molecular and genomic alterations in glioblastoma multiforme","volume":"185","author":"Crespo","year":"2015","unstructured":"Crespo IVital ALGonzalez-Tablas MMolecular and genomic alterations in glioblastoma multiforme. Am J Pathol. 2015;185(7):1820-1833."},{"issue":"8","key":"bib11","series-title":"Neuro-Oncology","first-page":"1231","article-title":"The 2021 WHO Classification of Tumors of the central nervous system: a summary","volume":"23","author":"Louis","year":"2021","unstructured":"Louis DNPerry AWesseling PThe 2021 WHO Classification of Tumors of the central nervous system: a summary. Neuro-Oncology. 2021;23(8):1231-1251."},{"issue":"1","key":"bib12","series-title":"Acta Neuropathol","first-page":"85","article-title":"Primary mismatch repair deficient IDH-mutant astrocytoma (PMMRDIA) is a distinct type with a poor prognosis","volume":"141","author":"Suwala","year":"2021","unstructured":"Suwala AKStichel DSchrimpf DPrimary mismatch repair deficient IDH-mutant astrocytoma (PMMRDIA) is a distinct type with a poor prognosis. Acta Neuropathol. 2021;141(1):85-100."},{"issue":"1","key":"bib13","series-title":"Neurooncol Adv","first-page":"vdad085","article-title":"Mismatch repair protein mutations in isocitrate dehydrogenase (IDH)-mutant astrocytoma and IDH-wild-type glioblastoma","volume":"5","author":"Richardson","year":"2023","unstructured":"Richardson TEYokoda RTRashidipour OMismatch repair protein mutations in isocitrate dehydrogenase (IDH)-mutant astrocytoma and IDH-wild-type glioblastoma. Neurooncol Adv. 2023;5(1):vdad085."},{"issue":"4","key":"bib14","series-title":"Am J Pathol","first-page":"1149","article-title":"IDH1 mutations are early events in the development of astrocytomas and oligodendrogliomas","volume":"174","author":"Watanabe","year":"2009","unstructured":"Watanabe TNobusawa SKleihues POhgaki H.IDH1 mutations are early events in the development of astrocytomas and oligodendrogliomas. Am J Pathol. 2009;174(4):1149-1153."},{"issue":"4","key":"bib15","series-title":"Neuro Oncol","first-page":"462","article-title":"A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method","volume":"15","author":"Walker","year":"2013","unstructured":"Walker DALiu JKieran MA multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method. Neuro Oncol. 2013;15(4):462-468."},{"issue":"1","key":"bib16","series-title":"Neuro Oncol","first-page":"81","article-title":"IDH1 mutant malignant astrocytomas are more amenable to surgical resection and have a survival benefit associated with maximal surgical resection","volume":"16","author":"Beiko","year":"2014","unstructured":"Beiko JSuki DHess KRIDH1 mutant malignant astrocytomas are more amenable to surgical resection and have a survival benefit associated with maximal surgical resection. Neuro Oncol. 2014;16(1):81-91."},{"issue":"1","key":"bib17","series-title":"Neuro-Oncology","first-page":"199","article-title":"Multi-institutional study of the frequency, genomic landscape, and outcome of IDH-mutant glioma in pediatrics","volume":"25","author":"Yeo","year":"2023","unstructured":"Yeo KKAlexandrescu SCotter JAMulti-institutional study of the frequency, genomic landscape, and outcome of IDH-mutant glioma in pediatrics. 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