Molecular and Pathological Features of Paediatric High-Grade Gliomas

Area of Science:

• Pediatric Oncology
• Neuro-oncology
• Molecular Pathology

Background:

• Paediatric high-grade gliomas (HGGs) are common childhood brain tumors.
• Despite morphological similarities to adult HGGs, distinct biological and molecular differences exist.
• Traditional histopathological classification is insufficient for accurate diagnosis and prognosis.

Purpose of the Study:

• To review the current diagnostic categories of paediatric HGGs.
• To highlight the critical role of molecular features in diagnosis and classification.
• To emphasize the shift towards molecular-based diagnostics in paediatric neuro-oncology.

Main Methods:

• Review of current literature and diagnostic guidelines.
• Focus on molecular alterations including histone 3, IDH1/2 mutations, and Receptor Tyrosine Kinase (RTK) fusions.
• Integration of molecular findings with histopathological classification as per WHO guidelines.

Main Results:

• Molecular classification has revolutionized paediatric HGG diagnosis.
• Specific molecular alterations (histone 3, IDH1/2, RTK fusions) are key diagnostic and prognostic markers.
• Current WHO classifications reflect this molecular shift, impacting patient management.

Conclusions:

• Molecular pathology is indispensable for the accurate diagnosis and classification of paediatric HGGs.
• Understanding these molecular features is essential for improving prognostic accuracy and therapeutic strategies.
• The diagnostic paradigm for paediatric HGGs has fundamentally changed due to molecular insights.