Cytologic Features of Subependymal Giant Cell Astrocytoma

Takei, Hiroyuki; Florez, Luisa; Bhattacharjee, Meenakshi B.

doi:10.1159/000325550

Cited by 16 publications

(21 citation statements)

References 9 publications

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“…Histopathologically, SEGAs are indistinguishable from subependymal nodules with loosely cohesive clusters of large cells with round to oval nuclei and no, or minimal, atypia; fi ne, evenly distributed chromatin; and abundant eosinophilic cytoplasm embedded in abundant thin, hairlike processes (Takei et al 2008 ) . Formed by three types of cells, fi brillated spindle cells, swollen gemistocytic-like cells and giant pyramidal cells with a ganglioid appearance, SEGAs show both glial and neuronal features.…”

Section: Histopathologymentioning

confidence: 96%

Tumors of the Central Nervous System, Volume 9

Hayat¹

2012

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Section: Histopathologymentioning

confidence: 96%

Tumors of the Central Nervous System, Volume 9

Hayat¹

2012

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“…Histopathologically, SEGAs are indistinguishable from subependymal nodules, with loosely cohesive clusters of large cells with round to oval nuclei and no (or minimal) atypia; fine, evenly distributed chromatin; and abundant eosinophilic cytoplasm embedded in abundant thin, hairlike processes [5]. Formed by three types of cells—fibrillated spindle cells, swollen gemistocytic-like cells, and giant pyramidal cells with a ganglioid appearance—SEGAs show both glial and neuronal features.…”

Section: Introductionmentioning

confidence: 99%

Subependymal Giant Cell Astrocytoma (SEGA) Treatment Update

Campen

Porter

2011

Curr Treat Options Neurol

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Opinion statement Rates of regrowth after resection of subependymal giant cell astrocytoma (SEGA) are low, making surgical resection a successful and permanent therapeutic strategy. In addition to surgical resection of SEGAs, other treatment options now include medications and Gamma Knife™ therapy. Advising patients on medical versus surgical management of SEGAs is currently not easy. SEGAs have been reported to regrow if mTOR inhibitor therapy is stopped, raising the possibility that long-term medication may be required to prevent tumor growth and hydrocephalus. The question of regrowth following medication withdrawal will need to be addressed in more patients to help establish the optimal duration of therapy. The risks of surgery include acute morbidity and the permanent need for ventriculoperitoneal shunting, which must be balanced against the adverse effects of mTOR inhibitors, including immunosuppression (infections, mouth sores), hypercholesterolemia, and the need for chronic drug monitoring. Some additional benefits of mTOR inhibition in patients with tuberous sclerosis complex, however, may include shrinkage of angiofibromas and angiomyolipomas as well as a possible decrease in seizure burden. Recent reports of successful nonsurgical treatment of SEGAs are promising, and it is hoped that further specifics on dosing, duration, and long-term outcome will help patients and physicians to make informed therapeutic choices. Present treatment recommendations for SEGAs include routine surveillance neuroimaging and close clinical follow-up, paying particular attention to signs and symptoms of acute hydrocephalus. If symptoms arise, or if serial neuroimaging demonstrates tumor growth, neurosurgical intervention is recommended. When gross total resection is impossible, rapamycin and everolimus should be considered, but may not offer a durable response.

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“…According to revised WHO classification of CNS tumors, SEGAs were included in the group of low astrocytic neoplasms. [1–3]…”

mentioning

confidence: 99%

“…Although rosettes and rosette-like structures may be observed in both tumors, the cells of ependymoma are smaller, with very scant cytoplasm. [1–4]…”

mentioning

confidence: 99%