H3K27M-mutant spinal cord and hemispheric tumor with prolonged survival: illustrative case
Bibliographic record
Abstract
BACKGROUND: H3K27M-altered diffuse midline glioma (DMG) is a recently classified tumor in the 2021 WHO classification of central nervous system tumors. Pediatric patients with H3K27M-altered DMG have a universally poor prognosis, with a median survival of 9-15 months. The prognosis of adult patients with the same tumor type is more variable, with rare cases of prolonged survival. OBSERVATIONS: The authors report the case of a 32-year-old male who presented with Brown-Séquard syndrome secondary to a heterogeneously enhancing intramedullary mass extending from T7 to T10. The lesion was resected, and the patient was diagnosed with an H3K27M-altered DMG. The patient presented again 29 months later with a nonenhancing right-sided temporal mass. This was again determined to be an H3K27M-mutated glioma with a molecular signature similar to the intramedullary mass. He received postoperative radiation therapy after each surgery and continued to survive well at the 42-month follow-up. LESSONS: The authors report the rare case of an adult-onset H3K27M midline glioma in the spinal cord and subsequent dissemination to the right temporal lobe with prolonged survival. This suggests that H3K27M-altered DMGs are heterogeneous entities with variable prognoses based on location and age. https://thejns.org/doi/10.3171/CASE24668.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".