{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:59:53Z","timestamp":1772517593571,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Diffuse midline glioma H3 K27-altered is a subtype of pediatric-type diffuse high-grade gliomas, characterized as an infiltrative high-grade glioma involving midline structures with H3 K27 mutation. This clinically rare entity poses diagnostic challenges in the early stages and carries an extremely poor prognosis. We report a case of diffuse midline glioma H3 K27-altered, primarily manifesting as spinal cord lesions, and detail its clinical characteristics to enhance understanding of this disease entity. A 21-year-old male presented with \u201cprogressive quadriparesis over 7 months.\u201d Seven months prior, he had developed bilateral lower limb weakness (grade II) following a cold. MRI at a local hospital revealed abnormal signals at T2\u2013T5, diagnosed as \u201cmyelitis.\u201d The disease progressed with lesion expansion despite treatment with glucocorticoid pulse therapy and intravenous immunoglobulin. The patient visited our hospital 7 months after the onset of the disease. At that time, the patient exhibited grade I muscle strength in the right upper limb and grade 0 in all other limbs, with sensory impairment below the neck. MRI revealed abnormal signals in the medulla oblongata and thoracic spinal cord. The patient received high-dose glucocorticoid pulse therapy again, but the symptoms did not improve despite treatment. The definitive diagnosis of diffuse midline glioma H3 K27-altered was established through spinal cord biopsy. The patient was discharged from the hospital due to respiratory failure 12 days post-diagnosis.<\/jats:p>","DOI":"10.3389\/fonc.2026.1658494","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:22:36Z","timestamp":1772515356000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: A case of diffuse midline glioma, H3 K27-altered presenting with long-segment spinal cord lesions"],"prefix":"10.3389","volume":"16","author":[{"given":"Chengcheng","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Neurology, People\u2019s Hospital of Henan University (Henan Provincial People\u2019s Hospital)","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songke","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, 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