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: Sujit Routray, M.D. [2]
Overview
If left untreated, patients with subependymal giant cell astrocytoma may progress to develop seizures, occlusion of the foramen of Monro with subsequent elevated intracranial pressure and obstructive hydrocephalus, infection, stroke, and death.[1] Common complications of subependymal giant cell astrocytoma include obstructive hydrocephalus, brain herniation, intratumoral hemorrhage, and infection.[2][3] Prognosis of subependymal giant cell astrocytoma is generally poor.[4]
Natural History
- Subependymal giant cell astrocytoma tends to grow slowly and is less likely to spread.[5]
- If left untreated, patients with subependymal giant cell astrocytoma may progress to develop seizures, occlusion of the foramen of Monro with subsequent elevated intracranial pressure and obstructive hydrocephalus, infection, stroke, and death.[1]
- New tumors hardly arise after 20-25 years of age.[5]
Complication
Common complications of subependymal giant cell astrocytoma include:[2][3]
- Obstructive hydrocephalus
- Brain herniation
- Intratumoral hemorrhage
- Infection
- Chronic ventriculoperitoneal shunt placement
- Stroke
- Sudden death
Prognosis
- Subependymal giant cell astrocytoma could be lethal, it is shown to be responsible for 25% of the excess mortality caused by the tuberous sclerosis complex.[6]
- Surgical resection and age under 18 years are significant positive prognostic factors.[7]
- Prognosis of subependymal giant cell astrocytoma is generally poor.[4]
- Poor prognostic factors for subependymal giant cell astrocytoma include:[5]
- Invasion to neighboring structures (fornix, hypothalamus, basal ganglia, or genu of internal capsule)
- Large sized tumors
- Recurrent tumors
References
- ↑ 1.0 1.1 Clinical presentation of subependymal giant cell astrocytoma. Dr. Bruno Di Muzio and Dr. Jeremy Jones et al. Radiopaedia 2015. http://radiopaedia.org/articles/subependymal-giant-cell-astrocytoma. Accessed on November 2, 2015
- ↑ 2.0 2.1 Surgery of subependymal giant cell astrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Subependymal_giant_cell_astrocytoma. Accessed on November 4, 2015
- ↑ 3.0 3.1 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.
- ↑ 4.0 4.1 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.
- ↑ 5.0 5.1 5.2 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.
- ↑ 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.