Presentation
Seizures.
Patient Data
Multiple calcified subependymal tubers are observed.
A large enhancing round mass is present in the subependymal location of the frontal horn of the right lateral ventricle. A similar characteristic lesion is noted in the anterior horn of the left lateral ventricle near the foramen of Monro. These lesions are causing mass effect and marked dilatation of the lateral ventricles, particularly on the right side. A midline shift of approximately 1.2 cm is observed towards the left side.
Case Discussion
The findings are characteristic of tuberous sclerosis and in this setting the bilateral masses at the foramina of Munro are almost certainly subependymal giant cell astrocytomas, resulting in proximal hydrocephalus.
Subependymal giant cell astrocytomas are WHO grade I (benign) tumors that are predominantly observed in young individuals diagnosed with tuberous sclerosis. These tumors can manifest either with no symptoms or with symptoms related to obstructive hydrocephalus.
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