Subependymal giant cell astrocytoma natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated, patients with subependymal giant cell astrocytoma may progress to develop | If left untreated, patients with subependymal giant cell astrocytoma may progress to develop symptoms of increased intracranial pressure. Common complications of subependymal giant cell astrocytoma include [[obstructive hydrocephalus]], [[brain herniation]], [[hemorrhage|intratumoral hemorrhage]], and [[infection]]. Prognosis of subependymal giant cell astrocytoma is generally poor. | ||
==Natural History, Complications, and Prognosis== | ==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 symptoms of increased intracranial pressure. Common complications of subependymal giant cell astrocytoma include obstructive hydrocephalus, brain herniation, intratumoral hemorrhage, and infection. Prognosis of subependymal giant cell astrocytoma is generally poor.
Natural History, Complications, and Prognosis
Natural History
- Subependymal giant cell astrocytoma's generally arise at 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 monroe 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][6]
- 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.[7]
- Surgical resection and age under 18 years are significant positive prognostic factors.[8]
- Prognosis of subependymal giant cell astrocytoma is generally poor.[9]
- 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.
- ↑ Surgery of subependymal giant cell astrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Subependymal_giant_cell_astrocytoma. Accessed on November 4, 2015
- ↑ 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.
- ↑ 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.
- ↑ 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.