Subependymal Giant Cell Astrocytoma

Fig 1&2: Axial and coronal MR images (contrast enhanced T1WI) show an enhancing mass in the left caudothalamic groove in a patient with known tuberous sclerosis. Given the size and enhancement on this initial scan, a concern of SGCA should be raised.

Subependymal giant cell astrocytoma (SGCA)

• 1 in 10 individuals with TSC
• Arises from subependymal nodules
• Can result in ventricular obstruction
  
• It is recommended by the National Tuberous Sclerosis Association that brain imaging obtainend at every 1-3 years in children, up to the age of 21 years, to detect giant cell astrocytoma

Imaging Appearances That May Suggest SGCA

• Serial growth (best imaging predictor)
• Hydrocephalus
  
• Contrast enhancement
• Size >1 cm

Reference:
Goh S, Butler W, Thiele EA. Subependymal giant cell tumors in tuberous sclerosis complex. Neurology 2004;63:1457-1461.