title: Stereotactic endoscopic resection and surgical management of a subependymal giant cell astrocytoma: case report.
abstract: Subependymal giant cell astrocytomas (SEGAs) are benign tumors, most commonly associated with tuberous sclerosis complex (TSC). Arising from the lateral ependymal surface, these tumors may obstruct one or both foramina of Monro, resulting in hydrocephalus and often requiring treatment. Although interhemispheric-transcallosal and transcortical-transventricular approaches have been the standard methods for resecting these tumors, advances in neuroendoscopic techniques have expanded SEGAs as a potential target for endoscopic resection.   The authors present a case of an endoscopically resected SEGA with stereotactic guidance in a 4-year-old girl with TSC. A gross-total resection of an enlarging SEGA was achieved. This represents one of the early case reports of endoscopically resected SEGAs. Although recent advances in medical treatment for SEGAs with mammalian target of rapamycin (mTOR) pathway inhibitors have shown promising initial results, the long-term safety and efficacy of mTOR inhibitors has yet to be determined. The propensity of these tumors to cause obstructive hydrocephalus requires that a surgical option remain. Neuroendoscopic approaches may allow a safe and effective technique.
authors.affiliation: Department of Neurosurgery, Division of Pediatric Neurosurgery, New York University Langone Medical Center, New York, NY 10016, USA. Shaun.Rodgers@nyumc.org
authors.forename: Shaun D
authors.initials: SD
authors.lastname: Rodgers
authors.forename: Luigi
authors.initials: L
authors.lastname: Bassani
authors.forename: Howard L
authors.initials: HL
authors.lastname: Weiner
authors.forename: David H
authors.initials: DH
authors.lastname: Harter
mesh_terms: D001254:Astrocytoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D013238:Stereotaxic Techniques; D016896:Treatment Outcome