Congenital subpendymal giant cell astrocytoma in children with tuberous sclerosis complex: growth patterns and neurological outcome
Background Literature regarding congenital subependymal giant cell astrocytomas (SEGA) is limited, and suggests they are at risk of rapid growth and complications. We sought to characterise the growth patterns of congenital SEGA. The second part of the study was an exploratory analysis of congenital...
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Veröffentlicht in: | Pediatric research 2021-05, Vol.89 (6), p.1447-1451 |
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Sprache: | eng |
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Zusammenfassung: | Background
Literature regarding congenital subependymal giant cell astrocytomas (SEGA) is limited, and suggests they are at risk of rapid growth and complications. We sought to characterise the growth patterns of congenital SEGA. The second part of the study was an exploratory analysis of congenital SEGA as a possible biomarker for poor neurological outcome.
Methods
This single-centre case series describes ten patients with TSC who had SEGA diagnosed before 12 months. SEGA diameter and volumetric growth were analysed using serial MRIs. Neurological outcomes were compared to a genotype-matched group.
Results
All children with congenital SEGA had a
TSC2
mutation. Patients were followed for 1−8.7 years, during which median SEGA growth rate was 1.1 mm/yr in diameter or 150 mm
3
/yr volumetrically. SEGA with volume > 500 mm
3
had a significantly higher growth rate compared with smaller SEGA (462 mm
3
/yr vs. 42 mm
3
/yr,
p
= 0.0095). Children with congenital SEGA had a high prevalence of severe epilepsy, developmental disability and autism spectrum disorder.
Conclusion
Congenital SEGA can follow a relatively benign course with a lower growth rate compared with published literature. Frequent neuroimaging surveillance is recommended for congenital SEGA with volumes exceeding 500 mm
3
.
Impact
Congenital SEGA occur in 9.2% of paediatric patients with tuberous sclerosis complex.
There are few published cases of congenital SEGA to date. This case series of ten patients adds our experience seen in a tertiary referral hospital over 10 years.
Congenital SEGA can follow a relatively benign course with a lower growth rate compared with published literature.
Congenital SEGA with volume exceeding 500 mm
3
had a significantly higher growth rate compared with smaller SEGA and should have more frequent neuroimaging surveillance. |
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ISSN: | 0031-3998 1530-0447 |
DOI: | 10.1038/s41390-020-1002-7 |