A solitary extraventricular subependymal giant cell astrocytoma in the absence of tuberous sclerosis

Aparna P Tompe; Kiran M Sargar; Syed A Jaffar Kazmi; Nir Shimony

doi:10.1016/j.radcr.2020.11.004

A solitary extraventricular subependymal giant cell astrocytoma in the absence of tuberous sclerosis

Radiol Case Rep. 2020 Nov 16;16(1):180-184. doi: 10.1016/j.radcr.2020.11.004. eCollection 2021 Jan.

Authors

Aparna P Tompe¹, Kiran M Sargar², Syed A Jaffar Kazmi³, Nir Shimony⁴

Affiliations

¹ Research volunteer, Geisinger Medical Center, Danville, PA, USA.
² Department of Radiology, Geisinger Medical Center, Danville, PA, USA.
³ Department of Pathology, Geisinger Medical Center, Danville, PA, USA.
⁴ Department of Neurosurgery, Geisinger Medical Center, Danville, PA, USA.

Abstract

Subependymal giant cell astrocytomas (SEGAs) are the most common intracranial tumors in Tuberous Sclerosis Complex (TSC). Very few cases of solitary SEGA without a diagnosis of TSC have been described. Most of these previously reported solitary SEGAs were located near the caudothalamic groove or in close proximity to the lateral ventricles. Here, we describe a unique case of solitary extraventricular SEGA in a 17-year-old boy who presented with new-onset seizures in the absence of the clinical and genetic diagnosis of TSC. This extraventricular SEGA was involving white matter and cortex of the occipital lobe and was predominantly hypointense on T1 and T2-weighted images with a markedly hypointense signal on susceptibility-weighted images likely secondary to dense internal calcifications. Solitary SEGA can occur in the extraventricular location in patients without TSC and should be included in the differential diagnosis of a densely calcified supratentorial intra-axial tumor in children, especially during the second decade of life.

Keywords: Astrocytoma; Extraventricular; SEGA; Seizures; Solitary; TSC.

Publication types

Case Reports