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Subependymal giant cell astrocytoma associated with tuberous sclerosis presenting with intratumoral bleeding. Case report and review of literature

Child's Nervous System volume 29, pages 335–339 (2013)Cite this article

Abstract

The authors describe a rare case of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex that presented with intratumoral bleeding with extension to the ventricles. The literature regarding intracranial hemorrhage of SEGA is reviewed and only five cases have been reported in the literature. We have not identified a histological feature associated with bleeding.

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References

  1. Al-Jarallah A, Al-Rifai MT, Riela AR, Roach ES (2000) Nontraumatic brain hemorrhage in children: etiology and presentation. J Child Neurol 15:284–289

    PubMed  Article  CAS  Google Scholar 

  2. Arbiser JL, Brat D, Hunter S, D’Armiento J, Henske EP, Arbiser ZK, Bai X, Goldberg G, Cohen C, Weiss SW (2002) Tuberous sclerosis-associated lesions of the kidney, brain and skin are angiogenic neoplasms. J Am Acad Dermatol 46:376–380

    PubMed  Article  Google Scholar 

  3. Arita K, Kurisu K, Tominaga A, Sugiyama K, Eguchi K, Hama S, Yoshioka H, Yamasaki F, Kanou Y (2004) Relationship between intratumoral hemorrhage and overexpression of vascular endothelial growth factor (VEGF) in pituitary adenoma. Hiroshima J Med Sci 53:23–27

    PubMed  CAS  Google Scholar 

  4. Barbosa-Coutinho LM, Lima EL, Gadret RO, Ferreira NP (1991) Hemorragia maciça intratumoral em esclerose tuberosa. Arq Neuropsiquiatr 49:465–470

    PubMed  Article  CAS  Google Scholar 

  5. Buccoliero AM, Franchi A, Castiglione F, Gheri CF, Mussa F, Giordano F (2009) Subependymal giant cell astrocytoma (SEGA): is it an astrocytoma? Morphological, immunohistochemical and ultrastructural study. Neuropathology 29:25–30

    PubMed  Article  Google Scholar 

  6. Cheng SY, Nagane M, Huang HS, Cavenee WK (1997) Intracerebral tumor-associated hemorrhage caused by overexpression of the vascular endothelial growth factor isofroms VEGF121 an VEGF165 but not VEGF189. Proc Natl Acad Sci USA 94:12081–12087

    PubMed  Article  CAS  Google Scholar 

  7. Chow CW, Klug GL, Lewis EA (1988) Subependymal giant cell astrocytoma in children: an unusual discrepancy between histological and clinical features. J Neurosurg 68:880–883

    PubMed  Article  CAS  Google Scholar 

  8. Cuccia V, Zuccaro G, Sosa F, Monges J, Lubieneky F, Taratuto A (2003) Subependymal giant cell astrocytoma in children with tuberous sclerosis. Child Nerv Syst 19:232–243

    Google Scholar 

  9. Frèrebeau P, Benezech J, Segnarbieux F, Harbi H, Desy A, Marty-Double C (1985) Intraventricular tumors in tuberous sclerosis. Childs Nerv Syst 1:45–48

    PubMed  Article  Google Scholar 

  10. Gottfried ON, Fults DW, Townsend JT, Couldwell WT (2003) Spontaneous hemorrhage associated with a pilomyxoid astrocytoma: case report. J Neurosurg 99:416–420

    PubMed  Article  Google Scholar 

  11. Hamamoto O, Honorato DC, Brito HLF, Souza-Queiroz L (1994) Intratumoral hemorrhage in tuberous sclerosis: case report. Arq Neuro-Psiquiatr 52:435–438

    Article  CAS  Google Scholar 

  12. Inamasu J, Nakamura Y, Saito R, Kuroshima Y, Mayanari K, Ischikizaki K (2005) Rebleeding from a primary brain tumor manifesting as intracerebral hemorrhage. Clin Neurol Neurosurg 108:105–108

    PubMed  Article  Google Scholar 

  13. Jung S, Moon KS, Jung TY, Kim IY, Lee YH, Rhu HH, Sun HS, Jeong YI, Kim KK, Kang SS (2006) Possible pathophysiological role of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) in metastatic brain tumor-associated intracerebral hemorrhage. J Neurooncol 76:257–263

    PubMed  Article  CAS  Google Scholar 

  14. Kalina P, Drehobi KE, Greenberg RW, Black KS, Hyman RA (1995) Hemorrhagic suependymal giant cell astrocytoma. Pedia Radiol 25:66–67

    Article  CAS  Google Scholar 

  15. Kato K, Moteki Y, Nakagawa M, Kadoyama S, Ujiie H (2011) Subaracnoid hemorrhage caused by pilocytic astrocytoma—case report. Neurol Med Chir 51:82–84

    Article  Google Scholar 

  16. Kim SK, Wang KC, Cho BK, Jung HW, Lee YJ, Chung YS, Lee JY, Park SH, KimYM CG, Chi JG (2001) Biological behavior and tumorigenesis of subependymal giant cell astrocytomas. J Neurooncol 52:217–225

    PubMed  Article  CAS  Google Scholar 

  17. Kondziolka D, Bernstein M, Resch L, Tator CH, Flemming JFR, Vandelinden RG, Schutz H (1987) Significance of hemorrhage into brain tumors: clinicopathological study. J Neurosurg 67:852–857

    PubMed  Article  CAS  Google Scholar 

  18. Kulmar R, Singh V (2004) Subependymal giant cell astrocytoma: a report of five cases. Neurosurg Rev 27:274–280

    Google Scholar 

  19. Kyrnetskiy EE, Kun LE, Boop FA, Sanford RA, Khan RB (2005) Types, causes, and outcome of intracranial hemorrhage in children with cancer. J Neurosurg 102(Suppl):31–35

    PubMed  Google Scholar 

  20. Mahdavi A, Baradaran N, Nejat F, Khashab ME, Monajemzadeh M (2010) Sudden deterioration due to intra-tumoral hemorrhage of ependymoma of the fourth ventricle in a child during a flight: a case report. J Med - Case Rep 4:143–146

    PubMed  Article  Google Scholar 

  21. Painter MJ, Pang D, Ahdab-Barmada M, Bergman I (1984) Connatal brain tumors in patients with tuberous sclerosis. Neurosurgery 14:570–573

    PubMed  Article  CAS  Google Scholar 

  22. Romeike BF, Joellenbeck B, Skalej M, Scherlach C, Kirches E, Mawrin C (2007) Intraventricular meningioma with fatal haemorrhage: clinical and autopsy findings. Clin Neurol Neurosurg 109:884–887

    PubMed  Article  Google Scholar 

  23. Salcman M (1992) Intracranial hemorrhage caused by brain tumor. In: Kaufman HH (ed) Intracerebral Hematomas. Raven, New York, pp 95–106

    Google Scholar 

  24. Scheithauer BW (1992) The neuropathology of tuberous sclerosis. J Dermatol 19:897–903

    PubMed  CAS  Google Scholar 

  25. Stravinou P, Spiliotoupoulos A, Patsalas I, Balogiannis I, Karkavelas G, Polyzoidis K, Seeelviaridis P (2008) Subependymal giant cell astrocytoma with intratumoral hemorrhage in the absense of tuberous sclerosis. J Clin Neurosci 15:704–706

    Article  Google Scholar 

  26. Waga S, Yamamoto Y, Kojima T, Sakakura M (1977) Massive hemorrhage in tumor of tuberous sclerosis. Surg Neurol 8:99–101

    PubMed  CAS  Google Scholar 

  27. Krueger DA, Care MM, Holland K, Agricola K, Tudor C, Mangeshkar P et al (2010) Everolimus for subependymal giant cell astrocytomas in tuberous sclerosis. N Engl Med 363:1801–1811

    Article  CAS  Google Scholar 

  28. Yalon M, Ben-Sira L, Constantini S, Toren A (2011) Regression of subependymal giant cell astrocytomas with RAD001 (Everolimus) in tuberous sclerosis complex. Childs Nerv Syst 27:179–181

    PubMed  Article  Google Scholar 

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The authors report that they did not have any conflict of interest concerning the material or methods used in this study or the findings specified in this paper.

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Authors and Affiliations

  1. Pediatric Neurosurgery Unit, Division of Neurosurgery, Hospital das Clínicas, São Paulo University Medical School, São Paulo, Brazil

    Hugo Sterman, Andre Beer Furlan, Hamilton Matushita & Manoel Jacobsen Teixeira

  2. Pediatric Neurosurgery, São Paulo University Medical School, São Paulo, Brazil

    Hugo Sterman, Andre Beer Furlan & Hamilton Matushita

  3. Department of Neurosurgery, São Paulo University Medical School, São Paulo, Brazil

    Manoel Jacobsen Teixeira

  4. Rua Barata Ribeiro, 237-cj 43/44/46, 01308000, Bela Vista, São Paulo, Brazil

    Hamilton Matushita

Authors
  1. Hugo Sterman
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  2. Andre Beer Furlan
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  3. Hamilton Matushita
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  4. Manoel Jacobsen Teixeira
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Correspondence to Hamilton Matushita.

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Sterman, H., Furlan, A.B., Matushita, H. et al. Subependymal giant cell astrocytoma associated with tuberous sclerosis presenting with intratumoral bleeding. Case report and review of literature. Childs Nerv Syst 29, 335–339 (2013). https://doi.org/10.1007/s00381-012-1962-y

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  • DOI: https://doi.org/10.1007/s00381-012-1962-y

Keywords

  • Subependymal giant cell astrocytoma
  • Tuberous sclerosis
  • Intratumoral hemorrhage
  • Intraventricular hemorrhage