Subependymal Giant Cell Astrocytoma (SEGA)
Subependymal Giant Cell Astrocytoma (SEGA)
- Subependymal giant cell astrocytomas are benign, astrocytic tumors (like pilocytic astrocytoma).
- They are almost exclusively found in pediatric patients with tuberous sclerosis.
- Like subependymomas and colloid cysts, they often present with pathologic obstructive hydrocephalus.
- Because they position themselves at/near the foramen of Monro, the hydrocephalus can be deadly.
- On MRI, they have heterogenous signal intensity, demonstrate calcifications, and have marked contrast enhancement, which distinguishes them from subependymomas, which typically display homogenous signal intensity and lack contrast enhancement.
- Note that the "candle gutterings" are sub-ependymal nodules found in tuberous sclerosis: they are smooth, round projections into the ventricles that look like drippings of wax along a candle.
References
- Adesina, Adekunle M., Tarik Tihan, Christine E. Fuller, and Tina Young Poussaint. Atlas of Pediatric Brain Tumors. Springer, 2016.
- Louis, David N., Arie Perry, Guido Reifenberger, Andreas von Deimling, Dominique Figarella-Branger, Webster K. Cavenee, Hiroko Ohgaki, Otmar D. Wiestler, Paul Kleihues, and David W. Ellison. “The 2016 World Health Organization Classification of Tumors of the Central Nervous System: A Summary.” Acta Neuropathologica 131, no. 6 (June 1, 2016): 803–20. https://doi.org/10.1007/s00401-016-1545-1.
- Molavi, Diana Weedman. The Practice of Surgical Pathology: A Beginner’s Guide to the Diagnostic Process. Springer Science & Business Media, 2008.
- Orkin, Stuart H., David E. Fisher, A. Thomas Look, Samuel Lux, David Ginsburg, and David G. Nathan. Oncology of Infancy and Childhood E-Book. Elsevier Health Sciences, 2009.
- “December 27, 2010 e-Pearl of the Week: ‘Candle Guttering’ Sign in Tuberous Sclerosis | Neurology.” Accessed August 6, 2018. http://n.neurology.org/epearls/20101227.