Brain Tumor Pathology

, Volume 28, Issue 1, pp 53–57 | Cite as

Subependymal giant cell astrocytoma with oncocytic change

  • Satoshi UtsukiEmail author
  • Hidehiro Oka
  • Chihiro Kijima
  • Yoshie Yasui
  • Kiyotaka Fujii
  • Nobuyuki Kawano
  • Saburo Yagishita
Case Report


A 49-year-old woman presented with a history of periodic episodes of nausea and vomiting starting in 2006. In June 2009, the patient lost consciousness and was transported to our hospital. Head computed tomography (CT) revealed hydrocephalus caused by an enhancing mass lesion with calcification located in the right lateral ventricle around the foramen of Monro. Total tumor removal was performed. Histologic findings revealed fibrillated spindle tumor cells and giant tumor cells with abundant cytoplasm. The spindle tumor cells were immunoreactive for GFAP and S-100 protein, but none of the giant tumor cells were immunoreactive for GFAP or S-100 protein. Electron microscopic examination revealed abundant mitochondria in the tumor cell cytoplasm. According to these findings, this tumor was diagnosed as subependymal giant cell astrocytoma (SEGA) with oncocytic change, which is extremely rare.


Intraventricular tumor Calcification Hydrocephalus Subependymal giant cell astrocytoma Oncocytic change 


  1. 1.
    Jozwiak J, Jozwiak S, Wlodarski P (2008) Possible mechanisms of disease development in tuberous sclerosis. Lancet Oncol 9:73–79CrossRefPubMedGoogle Scholar
  2. 2.
    Roach ES, Gomez MR, Northrup H (1998) Tuberous sclerosis complex consensus conference: revised clinical diagnostic criteria. J Child Neurol 13:624–628CrossRefPubMedGoogle Scholar
  3. 3.
    Altman NR, Purser RK, Post MJ (1988) Tuberous sclerosis: characteristics at CT and MR imaging. Radiology 167:527–532PubMedGoogle Scholar
  4. 4.
    Braffman BH, Bilaniuk LT, Naidich TP et al (1992) MR imaging of tuberous sclerosis: pathogenesis of this phakomatosis, use of gadopentetate dimeglumine, and literature review. Radiology 183:227–238PubMedGoogle Scholar
  5. 5.
    Menor F, Marti-Bonmati L, Mulas F et al (1992) Neuroimaging in tuberous sclerosis: a clinicoradiological evaluation in pediatric patients. Pediatr Radiol 22:485–489CrossRefPubMedGoogle Scholar
  6. 6.
    Nabbout R, Santos M, Rolland Y et al (1999) Early diagnosis of subependymal giant cell tumor in children with tuberous sclerosis. J Neurol Neurosurg Psychiatry 66:370–375CrossRefPubMedGoogle Scholar
  7. 7.
    Fujiwara S, Takaki T, Hikita T et al (1989) Subependymal giant-cell atrocytoma associated with tuberous sclerosis. Do subependymal nodules qrow? Childs Nerv Syst 5:43–44CrossRefPubMedGoogle Scholar
  8. 8.
    Jozwiak J, Jozwiak S, Skopinski P (2005) Immunohistochemical and microscopic studies on giant cells in tuberous sclerosis. Histol Histopathol 20:1321–1326PubMedGoogle Scholar
  9. 9.
    Roszkowski M, Drabik K, Barszcz S et al (1995) Surgical treatment of intraventricular tumors associated with tuberous sclerosis. Childs Nerv Syst 11:335–339CrossRefPubMedGoogle Scholar
  10. 10.
    Huang MC, Kubo O, Tajika Y et al (1995) Immunohistochemical and electron microscopic study of subependymal giant cell astrocytoma. Brain Tumor Pathol 12:117–123Google Scholar
  11. 11.
    Taraszewska A, Kroh H, Majchrowski A (1997) Subependymal giant cell astrocytoma: clinical, histologic and immunohistochemical characteristic of 3 cases. Folia Neuropathol 35:181–186PubMedGoogle Scholar
  12. 12.
    Bonnin JM, Rubinstein LJ, Papasozomenos SC et al (1984) Subependymal giant cell astrocytoma. Significance and possible cytogenetic implications of an immunohistochemical study. Acta Neuropathol 62:185–193CrossRefPubMedGoogle Scholar
  13. 13.
    Buccoliero AM, Franchi A, Castiglione F et al (2009) Subependymal giant cell astrocytoma (SEGA): is it an astrocytoma? Morphological, immunohistochemical and ultrastructural study. Neuropathology 29:25–30CrossRefPubMedGoogle Scholar
  14. 14.
    Morimoto K, Mogami H (1986) Sequential CT study of subependymal giant-cell astrocytoma associated with tuberous sclerosis. Case report. J Neurosurg 65:874–877CrossRefPubMedGoogle Scholar
  15. 15.
    Shintaku M, Itoh M (2000) Astrocytoma with angiomatoid vascular proliferation (“angiomatous astrocytoma”). Clin Neuropathol 19:180–185PubMedGoogle Scholar
  16. 16.
    Kawasaki S, Yamamoto Y, Sunami N et al (1999) Subependymal giant cell astrocytoma associated with tuberous sclerosis exhibiting rapid regrowth after 17 years: a case report. (in Japanese) No Shinkei Geka 27:550–556PubMedGoogle Scholar
  17. 17.
    Kalina P, Drehobl KE, Greenberg RW et al (1995) Hemorrhagic subependymal giant cell astrocytoma. Pediatr Radiol 25:66–67CrossRefPubMedGoogle Scholar
  18. 18.
    Stavrinou P, Spiliotopoulos A, Patsalas I et al (2008) Subependymal giant cell astrocytoma with intratumoral hemorrhage in the absence of tuberous sclerosis. J Clin Neurosci 15:704–706CrossRefPubMedGoogle Scholar
  19. 19.
    Lopes MBS, Wiestler OD, Stemmer-Rachamimov AO et al (2007) Tuberous complex ad subependymal giant cell astrocytoma. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds) WHO classification of tumours of the central nervous system, 4th edn. IARC Press, Lyon, pp 218–221Google Scholar

Copyright information

© The Japan Society of Brain Tumor Pathology 2010

Authors and Affiliations

  • Satoshi Utsuki
    • 1
    Email author
  • Hidehiro Oka
    • 1
  • Chihiro Kijima
    • 1
  • Yoshie Yasui
    • 1
  • Kiyotaka Fujii
    • 1
  • Nobuyuki Kawano
    • 2
  • Saburo Yagishita
    • 3
  1. 1.Department of NeurosurgeryKitasato University School of MedicineSagamiharaJapan
  2. 2.Isobe ClinicKanagawaJapan
  3. 3.Department of PathologyKanagawa Rehabilitation CenterKanagawaJapan

Personalised recommendations