Andrea Carai: A Neurosurgeon’s Perspective On DMG

Andrea Carai, Chief of Neurosurgical Oncology Unit at Bambino Gesù Children’s Hospital, made the following post on LinkedIn:

“Over the next few weeks I will be sharing on DIFFUSE MIDLINE GLIOMA (DMG) – please feel free to comment along the way!

A NEUROSURGEON’S PERSPECTIVE ON DMG: Part 1. WHAT IS THE DIAGNOSTIC OVERVIEW

• DMG is a group of gliomas exhibiting an exquisitely aggressive behaviour, most frequently arising in children 3-10 years old. They generally present in the depth of the brain, inside the brainstem or in the spinal cord.
• Initial symptoms progress rapidly and include alterations in eye and face movements, difficulties in speech and coordination of movements, imbalance when standing and walking. Diagnosis can be suspected on MRI. Tumor tissue typically infiltrates the brain and shows heterogeneous appearance with variable patterns of contrast enhancement.
• Definitive diagnosis can be made on tumor tissue with integrated histo-molecular analysis. Hallmark features include alterations of H3K27 or EZHIP genes, two main players in regulating DNA function.

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Current DMG classification is a recent acquisition (2021) and requires tissue sampling to obtain histo-molecular diagnosis. In selected cases of pontine gliomas (previously known as DIPG) MRI can be highly diagnostic and sufficient to start treatment, especially if symptoms are rapidly progressing or specific contraindications to surgery exist.”

Source: Andrea Carai/LinkedIn
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