Persistent communicating hydrocephalus in adult tuberous sclerosis patients: a possible therapeutic role for everolimus

Yosef Laviv, Steven Jackson, Zvi Harry Rappaport

Research output: Contribution to journalArticlepeer-review

Abstract

Subependymal giant cell tumor (SGCT) is a benign intraventricular tumor, usually located near the foramen of Monro. It is almost always associated with tuberous sclerosis complex (TSC). SGCTs may obstruct cerebrospinal fluid (CSF) pathways. Rarely, they may secrete a protein-rich exudate, causing communicating hydrocephalus. Surgery is indicated for symptomatic lesions or growing asymptomatic lesions. The operative approach to SGCT has shifted from simple shunt placement to a more aggressive approach, leading to early attempts at gross total resection. Recently, the mTOR inhibitor everolimus has been approved for treating SGCT. In this article, we present two cases of recurrent shunt malfunctions in adult TSC patients with protein-secreting SGCTs. We describe the complexity of treating such patients with an emphasis on the role mTOR inhibitors may have in their management. We also review the literature on surgical management of SGCT-related hydrocephalus.

Original languageEnglish
Pages (from-to)241-245
Number of pages5
JournalActa Neurochirurgica
Volume157
Issue number2
DOIs
StatePublished - 28 Jan 2015
Externally publishedYes

Keywords

  • Everolimus
  • Hydrocephalus
  • Subependymal giant cell tumor
  • Tuberous sclerosis

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