# Diffuse midline glioma, H3K27-altered, mimicking central neurocytoma on MRI: A case report

## TL;DR

A rare case of a brain tumor mimicking a different type on MRI is reported, highlighting the need for accurate diagnosis.

## Contribution

This is the first reported case of intraventricular diffuse midline glioma with a soap-bubble MRI appearance.

## Key findings

- The tumor was initially mistaken for central neurocytoma based on MRI features.
- Histopathological analysis confirmed it as H3K27-altered diffuse midline glioma.
- The case highlights the importance of considering this tumor in intraventricular mass differential diagnoses.

## Abstract

Diffuse midline glioma (DMG), H3K27-altered, is an aggressive central nervous system tumor that usually arises in midline structures such as the pons, thalamus, or spinal cord. We present a rare case of intraventricular DMG, H3K27-altered in a 35-year-old woman. MRI showed a soap-bubble appearance, initially suggestive of central neurocytoma, but histopathological and immunohistochemical analyses confirmed the final diagnosis of DMG, H3K27-altered. This is the first reported intraventricular DMG, H3K27-altered with a soap-bubble appearance, underscoring the importance of including this tumor in the differential diagnosis of intraventricular masses.