Abstract
Background: Subependymal giant cell astrocytomas (SEGAs) are rare slowly growing tumors that usually occur in the setting of tuberous sclerosis complex (TSC). Histologically they may simulate high-grade gliomas and such a misleading diagnosis might result in unnecessarily aggressive chemo-or radiotherapy. The aim of this study is to review the pathological pattern of SEGAs in two tertiary medical centres in the western region of Saudi Arabia. Methods: We retrospectively analyzed the pathological and clinical data of patients diagnosed with SEGAs in 2 tertiary medical centers (king Abdulaziz university hospital, [January 2000 to April 2012], and king Faisal specialist hospital and research center [January 2001 to April 2012]). Results: Ten cases were diagnosed as SEGAs. The age range was 5-35 years (mean 18.7 years). There were 5 Males and 5 female patients. Only three patients were diagnosed with TSC preoperatively and one patient diagnosed with TSC during the follow-up period. All the ten tumors developed in the lateral ventricles. All tumors showed similar histological features irrespective of their association with tuberous sclerosis. All the patients treated with complete microsurgical resection only. Clinical follow-up of the patients ranged from 2 to 144 months (mean 32 months), none of the patients had recurrence after surgery. Conclusion: SEGA should be considered in the differential diagnosis of intraventricular tumor even in the absence of TSC features. It is very important for pathologists to be aware with the morphological features of SEGA to avoid misdiagnosis and subsequent overtreatment. Surgical resection is usually sufficient treatment. Long term prognosis of patients with SEGA is excellent even in the presence of worrisome atypical histological features.