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Journals / Düzce Tıp Fakültesi Dergisi / 2026 / Volume: 28 Issue: 2

Atypical Extraventricular Cystic Subependymal Giant Cell Astrocytoma in a Child Who Did Not Fulfil Clinical Criteria for Tuberous Sclerosis Complex: A Diagnostic Pitfall—A Case Report

Mustafa Kaya(Sakarya University, Sakarya University Training and Research Hospital, Department of Neurosurgery)0000-0001-5548-4944
Muhammed Ömer Bakaç(Sakarya University, Sakarya University Training and Research Hospital, Department of Neurosurgery)0009-0003-1060-3067
Çağla Özdemir(Sakarya University, Sakarya University Training and Research Hospital, Department of Neurosurgery)0009-0007-7212-1556
Fahri Yılmaz(Sakarya University, Sakarya University Training and Research Hospital, Department of Neurosurgery)0000-0001-7965-6229
Pages
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Publication Date
2026-08-21
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This case highlights the integrated assessment required for pediatric cystic tumors with mural nodules.

📌 3 Key Takeaways

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Objective & Hypothesis:Subependymal giant cell astrocytoma (SEGA) usually arises near the foramen of Monro in patients with tuberous sclerosis complex (TSC).
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Key Findings & Data:A 14-year-old boy presented with headache and a 6.2 × 5.8 cm extraventricular, cyst-dominant hemispheric lesion containing a mildly enhancing mural nodule.
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Conclusion & Impact:This case highlights the integrated assessment required for pediatric cystic tumors with mural nodules.
🔬Design:Case Report
📍Scope:2021 Verileri
⚙️Variables:Astrocytoma · brain neoplasms · child

Abstract

Subependymal giant cell astrocytoma (SEGA) usually arises near the foramen of Monro in patients with tuberous sclerosis complex (TSC). A 14-year-old boy presented with headache and a 6.2 × 5.8 cm extraventricular, cyst-dominant hemispheric lesion containing a mildly enhancing mural nodule. Microsurgical excision was performed. Histology demonstrated mixed spindle and polygonal epithelioid/ganglioid cells in a fibrillary, microvascular stroma. Tumor cells were positive for glial fibrillary acidic protein (GFAP) and cluster of differentiation 56 (CD56); epithelial membrane antigen (EMA), inhibin, and thyroid transcription factor-1 (TTF-1) were negative, and the Ki-67 labeling index was approximately 1%. No additional major or minor feature of TSC was identified using the 2021 International TSC Consensus criteria. At 12 months, the patient was neurologically intact and headache-free. Germline or tumor TSC1/TSC2 testing and postoperative contrast-enhanced magnetic resonance imaging (MRI) were unavailable. This case highlights the integrated assessment required for pediatric cystic tumors with mural nodules.

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Cite This Article

Kaya, M., Bakaç, M. Ö., Özdemir, Ç., Yılmaz, F. (2026). Atypical Extraventricular Cystic Subependymal Giant Cell Astrocytoma in a Child Who Did Not Fulfil Clinical Criteria for Tuberous Sclerosis Complex: A Diagnostic Pitfall—A Case Report. Düzce Tıp Fakültesi Dergisi, Volume: 28 Issue: 2. https://doi.org/10.18678/dtfd.1904928

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