SDPS-08 OSSEOUS METASTASES IN H3G34-MUTANT DIFFUSE HEMISPHERIC GLIOMAS
نویسندگان
چکیده
Abstract Subset of patients with H3G34 gliomas may present extra-CNS metastasis further complicating both diagnosis and treatment. We describe a case 19-year-old female presenting initially focal motor seizure in right leg along pain. MRI the showed an ill-defined distal femur expansile osteolytic lesion central fluid signal, thick rim enhancement, endosteal scalloping, cortical invasion, smooth enhancing periosteal reaction/soft tissue extension associated surrounding marrow signal abnormality worrisome for extension. Contrast brain exhibited multiple frontal partial lobe T2 FLAIR hyperintense lesions. The largest demonstrated contrast internal foci restricted diffusion, focus intratumoral hemorrhage. A whole-body PET/CT intensely FDG-avid lytic femur, FDG activity biopsy tract. Hypermetabolic metastases to femoral head mid-sacral body were also observed. craniotomy two months later indicated preliminary histopathology malignant small round blue cell neoplasm. from was non-diagnostic malignancy but sacral bone reported neoplasm, consistent involvement by patient's known cranial Final pathological including molecular diagnostics WHO grade 4 IDH-wildtype mutant diffuse hemispheric glioma osseous metastases. Patient treated chemoradiotherapy temozolomide (TMZ). Following sixth cycle TMZ, imaging stable. Apart holocephalic headaches, patient had no significant medication side effects seizure-free. second PET scan improvement interval decrease uptake sacrum head. Given stress that can experience poor prognosis, it is imperative expand our knowledge ascertain accurate screening diagnostic methodologies.
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ژورنال
عنوان ژورنال: Neuro-oncology advances
سال: 2023
ISSN: ['2632-2498']
DOI: https://doi.org/10.1093/noajnl/vdad070.068