Response of subependymal giant cell astrocytoma with spinal cord metastasis to everolimus

J Pediatr Hematol Oncol. 2014 Oct;36(7):e448-51. doi: 10.1097/MPH.0000000000000005.

Abstract

Background: Brain subependymal giant cell astrocytomas (SEGAs) in patients with tuberous sclerosis have been reported to respond to everolimus.

Methods: A 15-year-old male patient with intractable seizures and multiple SEGAs of the brain developed leptomeningeal enhancement and multiple metastatic, histologically confirmed SEGAs of the spinal cord. He received daily everolimus at a dose of 3 mg/m for 6 weeks, which was then increased to 6 mg/m.

Results: Magnetic resonance image of the brain and spine showed significant reduction in the size of SEGAs after 6 weeks of treatment. The patient has remained free of progression for 24 months. Additional benefits included: excellent seizure control, decrease in the size of cardiac rhabdomyomas, and improved quality of life.

Conclusions: We describe a rare case of metastatic SEGA, which was successfully treated with everolimus.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use
  • Astrocytoma / drug therapy*
  • Astrocytoma / pathology
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / pathology
  • Everolimus
  • Humans
  • Male
  • Sirolimus / analogs & derivatives*
  • Sirolimus / therapeutic use
  • Spinal Cord Neoplasms / drug therapy*
  • Spinal Cord Neoplasms / secondary
  • Treatment Outcome
  • Tuberous Sclerosis / drug therapy
  • Tuberous Sclerosis / pathology

Substances

  • Antineoplastic Agents
  • Everolimus
  • Sirolimus