{"title":"Diagnostic and management challenge of a pediatric H3K27-altered glioma masquerading as vestibular schwannoma.","authors":"Jinquan Chen, Qiufeng Yin, Haibo Zhang","doi":"10.1007/s00247-025-06507-9","DOIUrl":null,"url":null,"abstract":"<p><p>Pediatric H3K27-altered glioma most frequently arises from midline cerebral parenchyma, whereas intracranial extra-axial locations are exceedingly rare. We report the case of an 8-year-old boy who presented with chronic-onset left-sided hearing impairment and peripheral facial paralysis. Radiological imaging identified an isolated cerebellopontine angle lesion distinct from surrounding structures. A vestibular schwannoma was diagnosed based on preoperative examinations. Surgical resection revealed an unusual facial nerve-infiltrating mass with distinct vascular features. Histopathological assessment yielded an unexpected diagnosis of H3K27-altered diffuse midline glioma, contrasting with initial preoperative impressions. This exceptional case illustrates diagnostic pitfalls in pediatric skull base pathologies and expands the recognized spectrum of diffuse midline gliomas.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1179-1182"},"PeriodicalIF":2.3000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00247-025-06507-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/13 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Pediatric H3K27-altered glioma most frequently arises from midline cerebral parenchyma, whereas intracranial extra-axial locations are exceedingly rare. We report the case of an 8-year-old boy who presented with chronic-onset left-sided hearing impairment and peripheral facial paralysis. Radiological imaging identified an isolated cerebellopontine angle lesion distinct from surrounding structures. A vestibular schwannoma was diagnosed based on preoperative examinations. Surgical resection revealed an unusual facial nerve-infiltrating mass with distinct vascular features. Histopathological assessment yielded an unexpected diagnosis of H3K27-altered diffuse midline glioma, contrasting with initial preoperative impressions. This exceptional case illustrates diagnostic pitfalls in pediatric skull base pathologies and expands the recognized spectrum of diffuse midline gliomas.
期刊介绍：
Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology
Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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