Subependymal giant cell astrocytoma:report of 6 cases

Abstract

Objective To study the clinical manifestations, radiological features, andpostoperative outcomes of patients with subependymal giant cell astrocytoma (SEGA). Methods Aretrospective analysis of the clinical presentations, imaging examinations, pathological features,treatments and follow-up results was conducted in 6 SEGA cases treated in our department from 2000 to2007. Results The most common clinical maifestations of SEGA included increased intracranialpressure and impaired visual acuity. CT scan of the tumors displayed isodensity or slightly increaseddensity with well defined border. Calcification was seen in some of the tumors. On T1-weighted magneticresonance images, the tumor masses presented with isointense or mixed signals, while on T2-weightedimages, the tumors exhibited isointense or hyperintense signals. The solid part of the tumor showedheterogeneous enhancement in contrast-enhanced imaging. No operative death occurred in these casesafter total removal of the tumors through a transcallosal approach (4 cases) or a frontal transcorticalapproach (2 cases). No postoperative tumor recurrence was found in the follow-up for 10 months to 8years. Conclusion The diagnosis of SGCA should be considered for the presence of tuberous sclerosisin the subependymal lesion adjacent to the foramen of Monro in cases presenting hydrocephalus orprogressive tumor growth. Surgical resection of the tumor should be performed as early as possible.SGCA is a benign tumor with good prognosis after a total resection. Regular follow-up examinationshould be undertaken to monitor the subependymal nodules for prevention of tumor recurrence. Key words: Subependymal giant cell astrocytoma; Tuberous sclerosis; Diagnosis