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Case #3

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Demographics: 7 years old, Male
Indication: Screening MRI in patient with tuberous sclerosis

Case #3

Findings

  • 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

Annotated Images & Illustrations

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.

Diagnosis

Subependymal giant cell astrocytoma (SEGA)

Key Imaging Features

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Differential Diagnosis

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Discussion

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Pearls

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References

  • Umeoka S, Koyama T, Miki Y, Akai M, Tsutsui K, Togashi K. Pictorial review of tuberous sclerosis in various organs. Radiographics 2008; 28(7).

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