SEGA MRI – Subependymal Giant Cell Astrocytoma. Axial and coronal MR images (contrast enhanced T1WI) show an enhancing mass in the left caudothalamic groove in a patient with known tuberous sclerosis. Given the size and enhancement on this initial scan, a concern of SGCA should be raised.

Subependymal giant cell astrocytoma (SGCA)

* 1 in 10 individuals with TSC
* Arises from subependymal nodules
* Can result in ventricular obstruction
* It is recommended by the National Tuberous Sclerosis Association that brain imaging obtainend at every 1-3 years in children, up to the age of 21 years, to detect giant cell astrocytoma

Imaging Appearances That May Suggest SGCA

* Serial growth (best imaging predictor)
* Hydrocephalus
* Contrast enhancement
* Size >1 cm

Reference:
Goh S, Butler W, Thiele EA. Subependymal giant cell tumors in tuberous sclerosis complex. Neurology 2004;63:1457-1461.

Case submitted / via our partner RiT