Surgical timing of the subependymal giant cell astrocytoma (sega) with the patients of tuberous sclerosis complex. .

Ekici, Mehmet; Kumandaş, Sefer; Per, Hüseyin; Ekici, Arzu; Tucer, Bülent; Gümüş, Hakan; Canöz, Özlem; Kurtsoy, Ali

doi:10.5137/1019-5149.jtn.4169-11.0

Cited by 6 publications

(3 citation statements)

References 31 publications

(58 reference statements)

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“…27 Although the exact surgical approach for individual patients must be determined based on the characteristics and location of the tumor, a transcortical or transcallosal approach is commonly used. 26,28,29 The use of minimally invasive endoscopic neurosurgery for the complete removal of a subependymal giant cell astrocytoma also has produced good results in individual patients, provided the tumors are less than 2 cm in diameter. [30][31][32][33] Larger lesions take too long to excise this way, removing a key benefit of endoscopic neurosurgery.…”

Section: Historical Treatment and Timingmentioning

confidence: 99%

Subependymal Giant Cell Astrocytomas in Patients With Tuberous Sclerosis Complex:

Wheless

Klimo

2013

J Child Neurol

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Tuberous sclerosis complex is a genetic disorder caused by mutations in either the TSC1 or TSC2 gene that can result in the growth of hamartomas in multiple organ systems. Subependymal giant cell astrocytomas are slow-growing brain tumors associated primarily with tuberous sclerosis complex. They are usually located in the ventricles, often near the foramen of Monro, where they can cause an obstruction if they grow too large, leading to increased intracranial pressure. Surgery to remove a tumor has been the mainstay of treatment but can be associated with postoperative morbidity and mortality. Not all tumors and/or patients are suitable for surgery. The recent development of mammalian target of rapamycin inhibitors that target the pathway affected by TSC1/TSC2 mutations offers a novel pharmacotherapeutic option for these patients. We review the timing and use of surgery versus pharmacotherapy for the treatment of subependymal giant cell astrocytoma in patients with tuberous sclerosis complex.

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Section: Historical Treatment and Timingmentioning

confidence: 99%

Subependymal Giant Cell Astrocytomas in Patients With Tuberous Sclerosis Complex:

Wheless

Klimo

2013

J Child Neurol

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“…9,42,44 Regardless, in the setting of acute hydrocephalus or tumor hemorrhage, it is our opinion that surgical excision will remain the mainstay of treatment and that endoscopic techniques may be the treatment of choice in carefully selected cases. 2,13,36,44 …”

Section: 44mentioning

confidence: 99%

“…3,5,[11][12][13]23,24,30,33,36,44 Multiple patient series have reported on the role of surgery in treating patients with SEGAs ( Table 3). The historical incidence of significant, and in some cases, permanent neurological morbidity has been documented (ranging from 5% to 50%).…”

Section: 43mentioning

confidence: 99%

A management strategy for intraventricular subependymal giant cell astrocytomas in tuberous sclerosis complex

Harter¹,

Bassani²,

Rodgers³

et al. 2014

PED

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Object Subependymal giant cell astrocytomas (SEGAs) are benign tumors, most commonly associated with tuberous sclerosis complex (TSC). The vast majority of these tumors arise from the lateral ependymal surface adjacent to the foramen of Monro, therefore potentially encroaching on one or both foramina, and resulting in obstructive hydrocephalus that necessitates surgical decompression. The indications for surgery, intraoperative considerations, and evolution of the authors' management paradigm are presented. Methods Patients with TSC who underwent craniotomy for SEGA resection at New York University Langone Medical Center between January 1997 and March 2011 were identified. Preoperative imaging, clinical characteristics, management decisions, operative procedures, and outcomes were reviewed. Results Eighteen patients with TSC underwent 22 primary tumor resections for SEGAs. The indication for surgery was meaningful radiographic tumor progression in 16 of 21 cases. The average age at the time of operation was 10.3 years. Average follow-up duration was 52 months (range 12–124 months). The operative approach was intrahemispheric-transcallosal in 16 cases, transcortical-transventricular in 5, and neuroendoscopic in 1. Nine tumors were on the right, 9 on the left, and 3 were bilateral. Gross-total resection was documented in 16 of 22 cases in our series, with radical subtotal resection achieved in 4 cases, and subtotal resection (STR) in 2 cases. Two patients had undergone ventriculoperitoneal shunt placement preoperatively and 7 patients required shunt placement after surgery for moderate to severe ventriculomegaly. Two patients experienced tumor progression requiring reoperation; both of these patients had initially undergone STR. Conclusions The authors present their management strategy for TSC patients with SEGAs. Select patients underwent microsurgical resection of SEGAs with acceptable morbidity. Gross-total resection or radical STR was achieved in 90.9% of our series (20 of 22 primary tumor resections), with no recurrences in this group. Approximately half of our patient series required CSF diversionary procedures. There were no instances of permanent neurological morbidity associated with surgery.

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Surgical resection of subependymal giant cell astrocytomas (SEGAs) and changes in SEGA-related conditions: a US national claims database study

Sun¹,

Krueger

Liu

et al. 2012

Current Medical Research and Opinion

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Surgical timing of the subependymal giant cell astrocytoma (sega) with the patients of tuberous sclerosis complex. .

Cited by 6 publications

References 31 publications

Subependymal Giant Cell Astrocytomas in Patients With Tuberous Sclerosis Complex:

Subependymal Giant Cell Astrocytomas in Patients With Tuberous Sclerosis Complex:

A management strategy for intraventricular subependymal giant cell astrocytomas in tuberous sclerosis complex

Surgical resection of subependymal giant cell astrocytomas (SEGAs) and changes in SEGA-related conditions: a US national claims database study

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