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Melthucelha Smith
Melthucelha Smith

Related Articles: "sega"



Diagnosis of SEGA has changed from pathology-based to imaging-based (6, 7), but formal diagnostic criteria have only been available since 2012, when an expert panel at the International Tuberous Sclerosis Complex Consensus Conference defined SEGA as a lesion at the caudothalamic groove with a size of >1 cm in any direction or a subependymal lesion at any location which has shown serial growth on consecutive imaging regardless of size (7). All SEGA-related studies performed before 2012 have been based on variable criteria, thus limiting the value of comparison (8).




Related articles: "sega"



Surgical resection (occasionally VP shunt alone) is the recommended intervention for acutely symptomatic individuals, while either surgical resection or medical therapy with mammalian/mechanistic target of rapamycin (mTOR) inhibitors can be effective for individuals with growing asymptomatic SEGA (13). Treatment decisions should be based on multiple factors such as the patient's clinical condition, anatomic considerations specific to SEGA, surgeon's experience, experience of the centre regarding use of mTOR inhibitors, prior history of SEGA resection, other TSC-related comorbidities, and patient/parental preference (7).


In this study, designed prior to the 2012 imaging-based consensus, prevalence, and growth of SEGA were defined as per clinical practice of the participating centres. We evaluated SEGA manifestations among adult patients (>18 years) enrolled into the TOSCA study. SEGA-related questions included in the case report form (CRF) were presence of single or multiple SEGA, newly diagnosed SEGA, SEGA growth, clinical signs, and symptoms associated with SEGA and information regarding SEGA treatment. In addition, possible associations of SEGA prevalence with genotype were analysed using a Chi-square test. Statistical significance was set at p-value


Radical and early surgery is the treatment of choice, it is associated with a better prognosis without complications, due partly to the intracranial hypertension and the association with tuberous sclerosis and the surgical procedure itself, which influences the functional and vital prognosis [5, 20, 21]. Recurrences are related to incomplete surgery.


The onset and growth of subependymal giant cell astrocytoma (SEGA) in tuberous sclerosis complex (TSC) typically occurs in childhood. There is minimal information on SEGA evolution in adults with TSC. Of 2,211 patients enrolled in TOSCA, 220 of the 803 adults (27.4%) ever had a SEGA. Of 186 patients with SEGA still ongoing in adulthood, 153 (82.3%) remained asymptomatic, and 33 (17.7%) were reported to ever have developed symptoms related to SEGA growth. SEGA growth since the previous scan was reported in 39 of the 186 adults (21%) with ongoing SEGA. All but one patient with growing SEGA had mutations in TSC2. Fourteen adults (2.4%) were newly diagnosed with SEGA during follow-up, and majority had mutations in TSC2. Our findings suggest that surveillance for new or growing SEGA is warranted also in adulthood, particularly in patients with mutations in TSC2.


First, Sega Europe senior vice president of commercial publishing John Clark is being promoted to executive vice president of publishing. In his new role, Clark will play a larger role in the company's publishing team, get involved in publishing-related strategic issues elsewhere in the business, and advise Post's successor on all publishing matters. 041b061a72


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