Laser interstitial thermal therapy for subependymal giant cell astrocytoma: technical case report

Abstract

<jats:p>Subependymal giant cell astrocytoma (SEGA) is a rare tumor occurring almost exclusively in patients with tuberous sclerosis complex. Although open resection remains the standard therapy, complication rates remain high. To minimize morbidity, less invasive approaches, such as endoscope-assisted resection, radiosurgery, and chemotherapy with mTOR pathway inhibitors, are also used to treat these lesions. Laser interstitial thermal therapy (LITT) is a relatively new modality that is increasingly used to treat a variety of intracranial lesions. In this report, the authors describe two pediatric cases of SEGA that were treated with LITT. In both patients the lesion responded well to this treatment modality, with tumor shrinkage observed on follow-up MRI. These cases highlight the potential of LITT to serve as a viable minimally invasive therapeutic approach to the management of SEGAs in the pediatric population.</jats:p>

Laser interstitial thermal therapy for pediatric atypical teratoid/rhabdoid tumor: case report

“…9 Dadey et al reported 2 pediatric cases of sub-ependymal giant cell astrocytoma (SEGA) treated with LITT, with both patients having significant improvement in symptoms and interval decrease in lesion size at the 9-month follow-up. 5 Tovar-Spinoza and Choi reported a series of 11 patients with 12 tumors including pilocytic astrocytoma, ependymoma, recurrent medulloblastoma, choroid plexus xanthogranuloma, SEGA, and ganglioglioma, in which 9 of the patients underwent LITT as initial therapy and 2 patients received it in an adjuvant fashion after other measures had failed. Postablation complications occurred in 2 patients, both of whom improved with rehabilitation with reduction of tumor volume in all instances.…”

Hyperthermia treatment advances for brain tumors

“…LITT has also been advocated for newly diagnosed and recurrent pediatric brain tumors [136]. LITT-treated pathologies include: pilocytic astrocytomas [136][137][138], ependymomas [77,103,139], medulloblastomas [136,138], choroid plexus xanthogranulomas [136,138], subependymal giant cell astrocytomas [136,138,[140][141][142], gangliogliomas [136,138,143], neuroectodermal tumors [77,103,144], gliosis [143], RN [143] and hypothalamic hamartomas [140]. Reported indications include deep-seated and recurrent, tumors [136,145].…”

Surgical Treatments of Epilepsy

“…Ideal candidates have evidence of a unilateral mesial temporal focus without neocortical temporal lobe involvement, 69,[76][77][78] hypothalamic hamartomas, 79 complex and deep focal cortical dysplasias, 80 tuberous sclerosis, 81 and subependymal giant cell astrocytomas. 82,83 LITT has also been used for disconnection procedures such as corpus callosotomy 84 and in combination with open temporal lobectomy and topectomy. 72,80,85 LITT can be repeated to augment the initial ablation if clinical results are suboptimal and/or if imaging reveals residual seizure focus.…”