Imaging characteristics and growth of subependymal giant cell astrocytomas.

Michelle J. Clarke, Andrew B. Foy, Nicholas Wetjen, Corey Raffel

Research output: Contribution to journalArticle

36 Citations (Scopus)

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.

Original languageEnglish (US)
JournalNeurosurgical Focus
Volume20
Issue number1
StatePublished - 2006

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Astrocytoma
Growth
Hydrocephalus
Neoplasms
Tuberous Sclerosis
Neuroimaging
Biopsy
Cerebral Ventricles
Signs and Symptoms
Seizures
Pediatrics
Morbidity

Cite this

Clarke, M. J., Foy, A. B., Wetjen, N., & Raffel, C. (2006). Imaging characteristics and growth of subependymal giant cell astrocytomas. Neurosurgical Focus, 20(1).

Imaging characteristics and growth of subependymal giant cell astrocytomas. / Clarke, Michelle J.; Foy, Andrew B.; Wetjen, Nicholas; Raffel, Corey.

In: Neurosurgical Focus, Vol. 20, No. 1, 2006.

Research output: Contribution to journalArticle

Clarke, MJ, Foy, AB, Wetjen, N & Raffel, C 2006, 'Imaging characteristics and growth of subependymal giant cell astrocytomas.', Neurosurgical Focus, vol. 20, no. 1.
Clarke, Michelle J. ; Foy, Andrew B. ; Wetjen, Nicholas ; Raffel, Corey. / Imaging characteristics and growth of subependymal giant cell astrocytomas. In: Neurosurgical Focus. 2006 ; Vol. 20, No. 1.
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