Abstract
AB013. Infantile brainstem high grade glioma: a case report
Shi Hui Ong1, Mervyn Jun Rui Lim2, Char Loo Tan3, Miriam Santiago Kimpo4, Balamurugan A. Vellayappan5, Ai Peng Tan6, Vincent Diong Weng Nga2
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore;
2Division of Neurosurgery, Department of Surgery, National University Hospital of Singapore, Singapore, Singapore;
3Department of Pathology, National University Hospital of Singapore, Singapore, Singapore;
4Division of Pediatric Hematology and Oncology, Department of Pediatrics, Khoo Teck Puat – National University Children’s Medical Institute, National University Hospital, Singapore, Singapore;
5Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore;
6Department of Diagnostic Imaging, National University Hospital of Singapore, Singapore, Singapore
Correspondence to: Shi Hui Ong, MD. Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr., Singapore 117597, Singapore. Email: shihui.sho@gmail.com.
Background: Congenital infantile brainstem high-grade gliomas (HGGs) are extremely rare. Given the limited literature characterizing this disease, management of these tumors remains challenging. Brainstem HGGs are generally associated with extremely poor prognosis. Limited reports of spontaneous regression of radiologically diagnosed infantile brainstem tumors exist in published literature. We aim to report a unique case of spontaneous regression of a rare infantile HGG brainstem glioma and to review the current literature.
Case Description: In this case report, we document the first histologically proven congenital brainstem HGG with molecular characteristics that did not fall under any previously well-defined pediatric brain tumor classifications. The patient is a full-term female delivered uneventfully via normal vaginal delivery with unremarkable antenatal and fetal abnormality scans. Neuroimaging revealed a relatively focal dorsally located pontomedullary tumor. She subsequently underwent suboccipital craniotomy and biopsy of the lesion. Formal histopathology revealed features consistent with HGG. Methylation profiling classified the neoplasm closest to either “glioblastoma, IDH wildtype, subclass midline” or “pediatric type diffuse HGG”. The patient’s post-operative recovery was uneventful. The initial plan was to consider safe surgical debulking when the child reaches 6 months of age. However, subsequent neuroimaging revealed spontaneous tumor regression after biopsy, up to 2 years of age. A review of the literature was also performed to identify previously reported infantile brainstem HGGs and the management for such tumors.
Conclusions: Our case highlights the value of performing histopathological confirmation to guide management and the possible existence of a subcategory of a congenital brainstem HGG with better prognosis.
Keywords: Brainstem; congenital; glioma; regression; case report
Acknowledgments
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab013/coif). The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Helsinki Declaration (as revised in 2013). Verbal consent has been obtained from the parents of the patient for the publication of this case report and accompanying images.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
Cite this abstract as: Ong SH, Lim MJR, Tan CL, Kimpo MS, Vellayappan BA, Tan AP, Nga VDW. AB013. Infantile brainstem high grade glioma: a case report. Chin Clin Oncol 2024;13(Suppl 1):AB013. doi: 10.21037/cco-24-ab013
