Fulminant leptomeningeal disease diagnosed as comutant H3F3A and FGFR diffuse midline glioma

Ann Clin Transl Neurol. 2024 Nov;11(11):3037-3041. doi: 10.1002/acn3.52180. Epub 2024 Oct 23.

Abstract

Diffuse midline gliomas present a particularly intricate and challenging clinical scenario. This rare case involves a patient with comutant H3F3A and FGFR diffuse midline glioma with a clinical presentation of fulminant leptomeningitis. A 22-year-old male presented with fatal and fulminant diffuse leptomeningitis. Next-generation sequencing of plasma and cerebrospinal circulating tumour DNA revealed diffuse midline gliomas with H3F3A and FGFR mutations. Methylome analysis of meningeal tissue collected during autopsy confirmed the diagnosis. Liquid biopsy plays a crucial role in the diagnosis of diffuse midline gliomas, mainly those with exclusively leptomeningeal presentations.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology
  • Fatal Outcome
  • Glioma* / diagnosis
  • Glioma* / genetics
  • Glioma* / pathology
  • Histones* / genetics
  • Humans
  • Male
  • Meningeal Neoplasms* / diagnosis
  • Meningeal Neoplasms* / genetics
  • Mutation
  • Receptors, Fibroblast Growth Factor / genetics
  • Young Adult

Substances

  • H3-3A protein, human
  • Histones
  • Receptors, Fibroblast Growth Factor