title: Response of subependymal giant cell astrocytoma with spinal cord metastasis to everolimus.
abstract: BACKGROUND
  Brain subependymal giant cell astrocytomas (SEGAs) in patients with tuberous sclerosis have been reported to respond to everolimus.
  
  
  METHODS
  A 15-year-old male patient with intractable seizures and multiple SEGAs of the brain developed leptomeningeal enhancement and multiple metastatic, histologically confirmed SEGAs of the spinal cord. He received daily everolimus at a dose of 3 mg/m for 6 weeks, which was then increased to 6 mg/m.
  
  
  RESULTS
  Magnetic resonance image of the brain and spine showed significant reduction in the size of SEGAs after 6 weeks of treatment. The patient has remained free of progression for 24 months. Additional benefits included: excellent seizure control, decrease in the size of cardiac rhabdomyomas, and improved quality of life.
  
  
  CONCLUSIONS
  We describe a rare case of metastatic SEGA, which was successfully treated with everolimus.
authors.affiliation: *Aflac Cancer and Blood Disorders Center ‡Department of Pathology, Children's Healthcare of Atlanta, Emory University School of Medicine Departments of †Neurology §Radiology ∥Neurosurgery, Children's Healthcare of Atlanta, Atlanta, GA.
authors.forename: Dolly
authors.initials: D
authors.lastname: Aguilera
authors.forename: Robert
authors.initials: R
authors.lastname: Flamini
authors.forename: Claire
authors.initials: C
authors.lastname: Mazewski
authors.forename: Matthew
authors.initials: M
authors.lastname: Schniederjan
authors.forename: Laura
authors.initials: L
authors.lastname: Hayes
authors.forename: William
authors.initials: W
authors.lastname: Boydston
authors.forename: Robert C
authors.initials: RC
authors.lastname: Castellino
authors.forename: Tobey J
authors.initials: TJ
authors.lastname: MacDonald
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy* / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000068338:Everolimus; D006801:Humans; D008297:Male; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013120:Spinal Cord Neoplasms / Q000188:drug therapy* / Q000556:secondary; D016896:Treatment Outcome; D014402:Tuberous Sclerosis / Q000188:drug therapy / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus; D020123:Sirolimus