IMG-33. EXPLORING RARE CASES OF SUBEPENDYMAL GIANT CELL ASTROCYTOMA (SEGA) IN PATIENTS WITH AND WITHOUT TUBEROUS SCLEROSIS COMPLEX (TSC): EXPERIENCE FROM INDONESIA

Abstract

Abstract INTRODUCTION Subependymal giant cell astrocytoma (SEGA) represents a rare type of brain tumor that predominantly manifests in individuals with tuberous sclerosis complex (TSC), a genetic disorder characterized by the growth of benign tumors in various organs. In radiology, SEGA exhibits distinct imaging characteristics in various modalities such as magnetic resonance imaging (MRI) and computed tomography (CT). Radiological features include well-defined intraventricular masses with variable enhancement patterns and associated hydrocephalus. Moreover, SEGA typically demonstrates signal characteristics consistent with glial tumors on MRI, aiding in differentiation from other intraventricular lesions. In TSC patients, SEGA often arises in association with other typical manifestations such as cortical tubers and subependymal nodules, facilitating diagnosis through multimodal imaging approaches. In contrast, SEGA occurring in non-TSC individuals presents challenges in diagnosis due to its rarity and lack of associated clinical features. CASE PRESENTATION Two patients with tuberous sclerosis complex exhibit intraventricular masses suggestive of SEGA, confirmed by histopathological results. Another patient, one patient with an intraventricular mass was suspected to have choroid plexus papilloma based on MRI findings; however, additional features correlated with SEGA. Histopathological examination subsequently confirmed the diagnosis of SEGA. CONCLUSION Radiological evaluation plays a crucial role in the assessment of SEGA, guiding treatment decisions and prognostic considerations. This abstract provides an overview of the radiological findings of SEGA in the context of TSC and non-TSC populations, highlighting the importance of imaging in managing this uncommon brain tumor.