๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
Case #3
1/25
ํ™˜์ž ์ •๋ณด: 7 ์„ธ, ๋‚จ์„ฑ
์ ์‘์ฆ: Screening MRI in patient with tuberous sclerosis

Case #3

์†Œ๊ฒฌ

  • Interval enlargement of an enhancing subependymal nodule near the right foramen of Monro measuring 1.5 x 1 cm
  • Multiple additional subcentimeter enhancing subependymal nodules
  • Multiple T2/FLAIR hyperintense cortical and juxtacortical lesions in the bilateral cerebral hemispheres
  • Dilated perivascular spaces in the right greater than left frontal white matter
  • No hydrocephalus
  • Right maxillary sinus mucous retention cyst. Mucosal thickening of bilateral ethmoid air cells

์ฃผ์„์ด ์žˆ๋Š” ์ด๋ฏธ์ง€ ๋ฐ ์ผ๋Ÿฌ์ŠคํŠธ

Enhancing subependymal nodule near the right foramen of Monro (red arrows) which demonstrates growth over a 3-year period, concerning for a subependymal giant cell astrocytoma in this patient with tuberous sclerosis.

Enhancing subependymal nodule near the right foramen of Monro (red arrows) which demonstrates growth over a 3-year period, concerning for a subependymal giant cell astrocytoma in this patient with tuberous sclerosis.

์ง„๋‹จ

Subependymal giant cell astrocytoma (SEGA)

์ฃผ์š” ์˜์ƒ ์†Œ๊ฒฌ

  • SEGAs are enhancing subependymal masses, commonly located near the foramen of Monro
  • While SEGAs can be difficult to distinguish from subependymal nodules, growth over time and size exceeding 1 cm favor SEGA

๊ฐ๋ณ„์ง„๋‹จ

  • No differential diagnosis in a patient with known tuberous sclerosis

๊ณ ์ฐฐ

  • Subependymal giant cell astrocytomas (SEGAs) are almost exclusively seen in patients with tuberous sclerosis
  • They are thought to arise from subependymal nodules and typically present in later childhood or adolescence
  • The primary concern with SEGAs is the development of hydrocephalus due to ventricular outflow obstruction at the foramen of Monro

ํ•ต์‹ฌ ํฌ์ธํŠธ

  • In a patient with tuberous sclerosis, an enlarging subependymal nodule exceeding 1 cm in size near the foramen of Monro is highly concerning for a SEGA
  • Watch closely for associated obstructive hydrocephalus

์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

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