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Case Report Open Access

Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report

  • Authors:
    • Pengwei Hou
    • Chengzhu Cai
    • Meiyan Liu
    • Xieli Guo
    • Mingfa Cai
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery, Shanghai Sixth People's Hospital Fujian, Jinjiang, Fujian 362200, P.R. China, Intensive Care Unit, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
    Copyright: © Hou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 235
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    Published online on: September 29, 2025
       https://doi.org/10.3892/etm.2025.12985
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Abstract

The present case report presents the diagnostic challenges of pediatric diffuse low‑grade glioma (pDLGG) with oligodendroglioma‑like features. The patient, an 11‑year‑old girl, presented with refractory epilepsy and brain imaging did not provide a clear diagnosis. Intraoperatively, the tumor appeared gray‑yellow to gray‑red, with moderate texture and unclear borders, consistent with LGG. Postoperative pathology showed diffuse infiltrative growth of the tumor, with pleomorphic cell morphology and oligodendroglioma‑like gliocyte proliferation. Staining was positive for markers such as glial fibrillary acidic protein and Olig‑2. Genomic analysis revealed BRAF V600E, fibroblast growth factor receptor (FGFR)1 and FGFR4 mutations, but no IDH mutations or other related mutations. The final diagnosis was pDLGG with alterations in the MAPK pathway. The present case underscores the importance of molecular and histological features in the diagnosis of pDLGG, especially when clinical and imaging characteristics are atypical, as molecular diagnostics provide key insights for disease classification.
View Figures

Figure 1

Preoperative cranial imaging. (A)
Cranial CT showed resorptive bone loss in the left parietal bone
(processed by 3D Slicer 5.7.1; https://slicer.org). (B-F) MRI imaging was performed.
(B) A large space-occupying lesion is observed in the left parietal
lobe, with associated compression of the contralateral ventricle.
(C) The lesion results in significant distortion of the surrounding
brain tissues and a rightward shift of the midline structures. (D)
Coronal view showing a lesion predominantly in the left
temporo-parieto-occipital region, with the parietal lobe as the
main site. (E) Sagittal view revealing peripheral enhancement and
compression of adjacent sulci and ventricles. (F) Axial view
demonstrating the mass. Red arrows and circles indicate the precise
location of the mass.

Figure 2

Intraoperative findings during
resection of a large intracranial mass. (A) Resected skull showing
partial resorptive bone loss in the parietal bone. (B) After scalp
elevation, part of the tumor was seen protruding through the bone
defect. (C) Intact dura mater observed after craniotomy. (D) The
tumor is a reddish, soft, uncapsulated and poorly demarcated lesion
with high vascularity.

Figure 3

Cranial MRI images at 3 days and 3
months post-surgery. (A) Axial T1-weighted image without contrast.
(B) Axial T2-weighted image. (C) Sagittal T1-weighted image. MRI
performed 3 days post-operation showed complete tumor resection,
with notable improvement in brain sulci and ventricular compression
compared with preoperative imaging. The midline had largely
returned to normal, with some residual fluid collection in the
surgical area and partial brain tissue expansion. (D) Axial
T1-weighted image. (E) Coronal T1-weighted image. (F) Sagittal
T1-weighted image Postoperative MRI at 3 months showed no signs of
tumor recurrence. Edema in the surgical area gradually subsided,
and ventricular expansion was noted. The yellow dashed box
indicates the surgical region.

Figure 4

Postoperative trends in CSF
parameters. T indicates postoperative days. The black curve
represents changes in CSF WBC count, the blue curve represents
changes in lactate levels and the red curve represents changes in
glucose levels. Postoperative intracranial infection was observed,
with a peak in CSF parameters shortly after surgery. Following
treatment with vancomycin and meropenem, the curves for WBC count,
lactate, and glucose levels demonstrated a downward trend. By T 11,
the patient's temperature had returned to normal. CSF,
cerebrospinal fluid; WBC, white blood cell; d, days.

Figure 5

Histopathology of the tumor. The
tumor tissue was histologically stained using hematoxylin and eosin
(x200 magnification). The image demonstrated a diffuse infiltrative
growth pattern characterized by low to moderate cellular density,
along with polymorphic cellular morphology and architectural
heterogeneity. Within the tumor, oligodendroglioma-like cells
exhibiting mild nuclear atypia (indicated by white arrows) and
perinuclear halos (black arrows) were observed.
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Copy and paste a formatted citation
Spandidos Publications style
Hou P, Cai C, Liu M, Guo X and Cai M: Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report. Exp Ther Med 30: 235, 2025.
APA
Hou, P., Cai, C., Liu, M., Guo, X., & Cai, M. (2025). Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report. Experimental and Therapeutic Medicine, 30, 235. https://doi.org/10.3892/etm.2025.12985
MLA
Hou, P., Cai, C., Liu, M., Guo, X., Cai, M."Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report". Experimental and Therapeutic Medicine 30.6 (2025): 235.
Chicago
Hou, P., Cai, C., Liu, M., Guo, X., Cai, M."Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report". Experimental and Therapeutic Medicine 30, no. 6 (2025): 235. https://doi.org/10.3892/etm.2025.12985
Copy and paste a formatted citation
x
Spandidos Publications style
Hou P, Cai C, Liu M, Guo X and Cai M: Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report. Exp Ther Med 30: 235, 2025.
APA
Hou, P., Cai, C., Liu, M., Guo, X., & Cai, M. (2025). Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report. Experimental and Therapeutic Medicine, 30, 235. https://doi.org/10.3892/etm.2025.12985
MLA
Hou, P., Cai, C., Liu, M., Guo, X., Cai, M."Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report". Experimental and Therapeutic Medicine 30.6 (2025): 235.
Chicago
Hou, P., Cai, C., Liu, M., Guo, X., Cai, M."Pediatric diffuse low‑grade glioma with oligodendroglioma‑like features: A case report". Experimental and Therapeutic Medicine 30, no. 6 (2025): 235. https://doi.org/10.3892/etm.2025.12985
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