View source for Subependymal giant cell astrocytoma natural history, complications and prognosis

__NOTOC__
{{Subependymal giant cell astrocytoma}}
{{CMG}} {{AE}}{{IO}}, {{SR}}

==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]].<ref name="RothRoach2013">{{cite journal|last1=Roth|first1=Jonathan|last2=Roach|first2=E. Steve|last3=Bartels|first3=Ute|last4=Jóźwiak|first4=Sergiusz|last5=Koenig|first5=Mary Kay|last6=Weiner|first6=Howard L.|last7=Franz|first7=David N.|last8=Wang|first8=Henry Z.|title=Subependymal Giant Cell Astrocytoma: Diagnosis, Screening, and Treatment. Recommendations From the International Tuberous Sclerosis Complex Consensus Conference 2012|journal=Pediatric Neurology|volume=49|issue=6|year=2013|pages=439–444|issn=08878994|doi=10.1016/j.pediatrneurol.2013.08.017}}</ref>
*It commonly presents in the first two decades of life.<ref name="pmid26942030">{{cite journal| author=Stein JR, Reidman DA| title=Imaging Manifestations of a Subependymal Giant Cell Astrocytoma in Tuberous Sclerosis. | journal=Case Rep Radiol | year= 2016 | volume= 2016 | issue=  | pages= 3750450 | pmid=26942030 | doi=10.1155/2016/3750450 | pmc=4752974 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26942030  }} </ref>
*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]].<ref name="pmid24138953">{{cite journal| author=Roth J, Roach ES, Bartels U, Jóźwiak S, Koenig MK, Weiner HL et al.| title=Subependymal giant cell astrocytoma: diagnosis, screening, and treatment. Recommendations from the International Tuberous Sclerosis Complex Consensus Conference 2012. | journal=Pediatr Neurol | year= 2013 | volume= 49 | issue= 6 | pages= 439-44 | pmid=24138953 | doi=10.1016/j.pediatrneurol.2013.08.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24138953  }} </ref>
*New [[tumors]] hardly arise after 20-25 years of age.<ref name="RothRoach2013">{{cite journal|last1=Roth|first1=Jonathan|last2=Roach|first2=E. Steve|last3=Bartels|first3=Ute|last4=Jóźwiak|first4=Sergiusz|last5=Koenig|first5=Mary Kay|last6=Weiner|first6=Howard L.|last7=Franz|first7=David N.|last8=Wang|first8=Henry Z.|title=Subependymal Giant Cell Astrocytoma: Diagnosis, Screening, and Treatment. Recommendations From the International Tuberous Sclerosis Complex Consensus Conference 2012|journal=Pediatric Neurology|volume=49|issue=6|year=2013|pages=439–444|issn=08878994|doi=10.1016/j.pediatrneurol.2013.08.017}}</ref>

==Complication==
Common complications of subependymal giant cell astrocytoma include:<ref name="pmid21465222">{{cite journal| author=Campen CJ, Porter BE| title=Subependymal Giant Cell Astrocytoma (SEGA) Treatment Update. | journal=Curr Treat Options Neurol | year= 2011 | volume= 13 | issue= 4 | pages= 380-5 | pmid=21465222 | doi=10.1007/s11940-011-0123-z | pmc=PMC3130084 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21465222  }} </ref><ref name="pmid23414132">{{cite journal| author=Ogiwara H, Morota N| title=Subependymal giant cell astrocytoma with intratumoral hemorrhage. | journal=J Neurosurg Pediatr | year= 2013 | volume= 11 | issue= 4 | pages= 469-72 | pmid=23414132 | doi=10.3171/2013.1.PEDS12403 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23414132  }} </ref>
*[[Obstructive hydrocephalus]]
*[[Brain herniation]]
*[[hemorrhage|Intratumoral hemorrhage]]
*[[ventriculoperitoneal shunt|Chronic ventriculoperitoneal shunt placement]]
*[[Stroke]]
*[[Sudden death]]

==Prognosis==
*[[Prognosis]] of subependymal giant cell astrocytoma is generally poor.<ref name="NabboutSantos1999">{{cite journal|last1=Nabbout|first1=R|last2=Santos|first2=M|last3=Rolland|first3=Y|last4=Delalande|first4=O|last5=Dulac|first5=O|last6=Chiron|first6=C|title=Early diagnosis of subependymal giant cell astrocytoma in children with tuberous sclerosis|journal=Journal of Neurology, Neurosurgery & Psychiatry|volume=66|issue=3|year=1999|pages=370–375|issn=0022-3050|doi=10.1136/jnnp.66.3.370}}</ref>
*It could be lethal, it is shown to be responsible for 25% of the excess [[mortality]] caused by the [[tuberous sclerosis complex]].<ref name="pmid25977907">{{cite journal| author=Jung TY, Kim YH, Jung S, Baek HJ, Lee KH| title=The clinical characteristics of subependymal giant cell astrocytoma: five cases. | journal=Brain Tumor Res Treat | year= 2015 | volume= 3 | issue= 1 | pages= 44-7 | pmid=25977907 | doi=10.14791/btrt.2015.3.1.44 | pmc=4426277 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25977907  }} </ref>
*[[Surgical resection]] and age under 18 years are significant positive prognostic factors.<ref name="pmid29966782">{{cite journal| author=Nguyen HS, Doan NB, Gelsomino M, Shabani S, Awad AJ, Best B et al.| title=Subependymal Giant Cell Astrocytoma: A Surveillance, Epidemiology, and End Results Program-Based Analysis from 2004 to 2013. | journal=World Neurosurg | year= 2018 | volume= 118 | issue=  | pages= e263-e268 | pmid=29966782 | doi=10.1016/j.wneu.2018.06.169 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29966782  }} </ref>
*Poor prognostic factors for subependymal giant cell astrocytoma include:<ref name="RothRoach2013">{{cite journal|last1=Roth|first1=Jonathan|last2=Roach|first2=E. Steve|last3=Bartels|first3=Ute|last4=Jóźwiak|first4=Sergiusz|last5=Koenig|first5=Mary Kay|last6=Weiner|first6=Howard L.|last7=Franz|first7=David N.|last8=Wang|first8=Henry Z.|title=Subependymal Giant Cell Astrocytoma: Diagnosis, Screening, and Treatment. Recommendations From the International Tuberous Sclerosis Complex Consensus Conference 2012|journal=Pediatric Neurology|volume=49|issue=6|year=2013|pages=439–444|issn=08878994|doi=10.1016/j.pediatrneurol.2013.08.017}}</ref>

:*Invasion to neighboring structures ([[fornix of brain|fornix]], [[hypothalamus]], [[basal ganglia]], or [[genu of internal capsule]])
:*Large sized [[tumors]]
:*Recurrent [[tumors]]

==References==
{{reflist|2}}

[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}