Faculty Collaboration Database

Imaging characteristics and growth of subependymal giant cell astrocytomas. Neurosurg Focus 2006 Jan 15;20(1):E5

Date

02/08/2006

Pubmed ID

16459995

DOI

10.3171/foc.2006.20.1.6

Scopus ID

2-s2.0-33646084883 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

OBJECT: Subependymal giant cell astrocytomas (SEGAs) are a common manifestation of tuberous sclerosis (TS). These evolving tumors have a propensity to cause obstructive hydrocephalus, usually due to obstruction at the level of the foramen of Monro. Differentiating SEGAs from subependymal nodules (SENs) before obstruction occurs may improve the morbidity associated with these tumors. In this study the authors' aim was to determine imaging characteristics of proven tumors in a single-center pediatric population.

METHODS: The authors retrospectively reviewed all records and images obtained in patients with TS in whom results of biopsy sampling had proven that their tumors were SEGAs. Time to presentation, signs and symptoms at presentation, and imaging characteristics of the evolving tumors were noted. Twelve patients with 14 SEGAs proven by the results of biopsy sampling were reviewed. Resection was recommended for symptomatic and neuroimaging evidence of hydrocephalus (41%), tumor growth without evidence of hydrocephalus (33%), and for poorly controlled seizures (25%). The mean diameter of the tumors at the time of resection was 1.9 cm (range 0.3-4 cm), and no tumor recurred. Because of the pathological and radiographic continuum of SENs and SEGAs, it remains difficult to predict whether and when a given lesion will progress. Tumor growth and contrast enhancement are the most common signs of progression on neuroimages, and may be seen prior to the development of obstructive hydrocephalus.

CONCLUSIONS: Patients with SENs and SEGAs should undergo follow-up neuroimaging at yearly intervals, and if lesions show signs of progression (contrast enhancement or growth), these intervals should be shortened and consideration given to early resection.

Author List

Clarke MJ, Foy AB, Wetjen N, Raffel C

Author

Andrew Foy MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Astrocytoma
Brain Neoplasms
Child
Child, Preschool
Female
Humans
Infant
Magnetic Resonance Imaging
Male
Retrospective Studies
Tomography, X-Ray Computed