SUBEPENDYMAL GIANT-CELL ASTROCYTOMAS IN CHILDREN

Between 1977 and 1991, at the Children's Hospital of Philadelphia, 10 patients, 5-16 years of age, were diagnosed as having subependymal gia nt cell astrocytomas. These patients accounted for 1.4% of all pediatr ic brain tumors seen during that time interval. One patient received a course of radiation therapy, which was ineffective in preventing tumo r growth. All underwent surgical resections with the goal being maxima l tumor debulking, if not complete resection. In 6 patients this was a ccomplished by the frontal transventricular route and, in the more rec ent patients, surgery was performed using a transcallosal approach. Th ere were 2 perioperative deaths, and 2 other patients died later of ca uses unrelated to tumor progression. The remaining 6 patients remain a live and stable at a mean of 6.7 years of follow-up (range 1.8-12.4). None of these patients has received additional radiation therapy. Two patients have no other evidence of tuberous sclerosis. The use of mode m radiographic and surgical techniques has made the treatment of this disease safer than in the past.