Subependymal giant-cell astrocytoma in children. An unusual discrepancy between histological and clinical features

The authors describe five cases of subependymal giant-cell astrocytoma in children in which many clinical, histological, immunohistochemical, and ultrastructural features typical of this tumor were present. However, prominent focal necrosis and mitoses, features usually associated with high-grade tumors, were seen in all cases. Despite the presence of necrosis and mitoses, clinical follow-up studies have revealed a lack of aggressive tumor behavior after surgery alone. The discrepancy between the histological and clinical features in these cases is emphasized so that excessive treatment of a basically low-grade tumor may be avoided. Mast cells were seen in all five cases, often in large numbers.