Subependymal giant-cell astrocytoma in tuberous sclerosis: Endoscopic images and the implications for therapy

Supratentorial intraventricular tumors are not freqently encountered in chi ldhood. One of the most frequent intraventricular glial tumors is the subep endymal giant-cell astrocytoma, mostly associated with tuberous sclerosis. These tumors are diagnosed on computed tomography (CT) or magnetic resonanc e imaging (MRI) scans. They can occur isolated or multiple and operative re section is advised if these tumors cause symptoms, usually raised intracran ial pressure due to obstructive hydrocephalus. However, the number of tumor s can be much higher than seen on radiological examination making total res ection of all tumors impossible. We demonstrate this with the endoscopic im ages derived during the endoscopic removal of a subependymal giant-cell ast rocytoma obstructing a foramen of Monro in a 15-year-old boy with tuberous sclerosis.