Subependymal giant cell astrocytoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2], Sujit Routray, M.D. [3]
Overview
Subependymal giant cell astrocytoma is generally located in the caudothalamic groove adjacent to the foramen of Monro and it presents commonly in the first two decades of life. It can lead to a few complications such as obstructive hydrocephalus, intratumoral hemorrhage, and death. Although the prognosis may be poor, patients who undergo surgical resection and those below the age of 18 have a better prognosis.
Natural History, Complications, and Prognosis
Natural History
- Subependymal giant cell astrocytoma's generally found in the caudothalamic groove adjacent to the foramen of Monro.[1]
- It commonly presents in the first two decades of life.[2]
- It is usually benign and slow growing but can progress to occluding the foramen of monro leading to obstructive hydrocephalus with symptoms of increased intracranial pressure.[3]
- New tumors hardly arise after 20-25 years of age.[1]
Complication
Common complications of subependymal giant cell astrocytoma include:[4][5]
- Obstructive hydrocephalus
- Brain herniation
- Intratumoral hemorrhage
- Chronic ventriculoperitoneal shunt placement
- Stroke
- Sudden death
Prognosis
- Prognosis of subependymal giant cell astrocytoma is generally poor.[6]
- It could be lethal, it is shown to be responsible for 25% of the excess mortality caused by the tuberous sclerosis complex.[7]
- Surgical resection and age under 18 years are significant positive prognostic factors.[8]
- Poor prognostic factors for subependymal giant cell astrocytoma include:[1]
- Invasion to neighboring structures (fornix, hypothalamus, basal ganglia, or genu of internal capsule)
- Large sized tumors
- Recurrent tumors
References
- ↑ 1.0 1.1 1.2 Roth, Jonathan; Roach, E. Steve; Bartels, Ute; Jóźwiak, Sergiusz; Koenig, Mary Kay; Weiner, Howard L.; Franz, David N.; Wang, Henry Z. (2013). "Subependymal Giant Cell Astrocytoma: Diagnosis, Screening, and Treatment. Recommendations From the International Tuberous Sclerosis Complex Consensus Conference 2012". Pediatric Neurology. 49 (6): 439–444. doi:10.1016/j.pediatrneurol.2013.08.017. ISSN 0887-8994.
- ↑ Stein JR, Reidman DA (2016). "Imaging Manifestations of a Subependymal Giant Cell Astrocytoma in Tuberous Sclerosis". Case Rep Radiol. 2016: 3750450. doi:10.1155/2016/3750450. PMC 4752974. PMID 26942030.
- ↑ Roth J, Roach ES, Bartels U, Jóźwiak S, Koenig MK, Weiner HL; et al. (2013). "Subependymal giant cell astrocytoma: diagnosis, screening, and treatment. Recommendations from the International Tuberous Sclerosis Complex Consensus Conference 2012". Pediatr Neurol. 49 (6): 439–44. doi:10.1016/j.pediatrneurol.2013.08.017. PMID 24138953.
- ↑ Campen CJ, Porter BE (2011). "Subependymal Giant Cell Astrocytoma (SEGA) Treatment Update". Curr Treat Options Neurol. 13 (4): 380–5. doi:10.1007/s11940-011-0123-z. PMC 3130084. PMID 21465222.
- ↑ Ogiwara H, Morota N (2013). "Subependymal giant cell astrocytoma with intratumoral hemorrhage". J Neurosurg Pediatr. 11 (4): 469–72. doi:10.3171/2013.1.PEDS12403. PMID 23414132.
- ↑ Nabbout, R; Santos, M; Rolland, Y; Delalande, O; Dulac, O; Chiron, C (1999). "Early diagnosis of subependymal giant cell astrocytoma in children with tuberous sclerosis". Journal of Neurology, Neurosurgery & Psychiatry. 66 (3): 370–375. doi:10.1136/jnnp.66.3.370. ISSN 0022-3050.
- ↑ Jung TY, Kim YH, Jung S, Baek HJ, Lee KH (2015). "The clinical characteristics of subependymal giant cell astrocytoma: five cases". Brain Tumor Res Treat. 3 (1): 44–7. doi:10.14791/btrt.2015.3.1.44. PMC 4426277. PMID 25977907.
- ↑ Nguyen HS, Doan NB, Gelsomino M, Shabani S, Awad AJ, Best B; et al. (2018). "Subependymal Giant Cell Astrocytoma: A Surveillance, Epidemiology, and End Results Program-Based Analysis from 2004 to 2013". World Neurosurg. 118: e263–e268. doi:10.1016/j.wneu.2018.06.169. PMID 29966782.