A Curious Case of T2-FLAIR Mismatch in H3K27M Mutant Glioma

Division

Far West

Hospital

Riverside Community Hospital

Document Type

Case Report

Publication Date

6-17-2022

Keywords

Adult brainstem glioma, Astrocytoma, Diffuse midline glioma, H3K27M mutation, IDH mutation, T2-FLAIR mismatch

Disciplines

Neoplasms | Nervous System Diseases | Neurology | Pathology | Radiology

Abstract

Diffuse midline gliomas are a rare relatively new classification of primary central nervous system tumors which include astrocytomas, oligodendrogliomas, and glioblastomas. The T2-FLAIR mismatch sign is regarded as a highly specific imaging feature of IDH-mutant, 1p/19q non-codeleted astrocytomas. The case presented herein demonstrates this sign, however, in a non-IDH mutated diffuse midline glioma with a H3K27M mutation, a World Health Organization Grade IV neoplasm. Although preoperative diagnosis can provide important treatment and prognostic information, it is often quite difficult particularly in primary central nervous system tumors.

Publisher or Conference

Radiology Case Reports

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