Subependymal Giant-cell Astrocytoma arising from the Trigone of the Lateral Ventricle Report of an Adult Case

• Published in: Neurologia medico-chirurgica Vol. 27; no. 3; pp. 202 - 207
• Main Authors: ANDOH, Takashi, KUMAGAI, Morio, KONDOH, Hiroaki, SAKAI, Noboru, YAMADA, Hiromu, SHIMOKAWA, Kuniyasu
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Japan Neurosurgical Society 1987
• Subjects: Adult; Astrocytoma - diagnostic imaging; Astrocytoma - pathology; Cerebral Ventricle Neoplasms - diagnostic imaging; Cerebral Ventricle Neoplasms - pathology; epilepsy; Humans; Male; Radiography; subependymal astrocytoma; temporal lobe; transient global amnesia; tuberous sclerosis
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.27.202

Subependymal giant-cell astrocytoma (SGCA), a rare intraventricular tumor, occurs mainly in young patients in conjunction with tuberous sclerosis (TS). This tumor arises characteristically from the medial part of the floor of the lateral ventricle, occluding the foramen of Monro. This report presents a rare adult case of SGCA, not associated with TS, which arose from the trigone of the lateral ventricle. The patient, a 42-year-old male, was admitted with episodes of psychomotor seizure for the past 2 years. The seizures consisted of hot sensations in his throat while breathing and of amnesic attacks. Electroencephalography showed occasional spike discharges localized in the right temporooccipital region. Computed tomography revealed the presence of an ovoid high density mass in the right trigone of the lateral ventricle with intense contrast enhancement. Surgery revealed a dark red, highly vascularized soft friable tumor. Light microscopic examination of the tumor characteristically showed cells of 3 morphological types, i.e. swollen gemistocytic cells, ganglion-like cells, and elongated and spindle-shaped cells. Mitoses and endothelial proliferations were extremely infrequent. Immunoreactive glial fibrillary acidic protein was present in the cytoplasm and processes of some smaller cells. Phosphotungstic-acid haematoxylin-positive fibrils were present in the perinuclear region of the spindle-shaped cells. Nissl's substances were seen at the margin of the cytoplasm of the ganglion-like giant cells.