Subependymal Giant Cell Astrocytoma Mimicking Recurrent Ependymoma: Imaging Clues to the Diagnosis of Tuberous Sclerosis Complex

Tuberous sclerosis complex (TSC), also known as Bourneville disease, is a multisystem genetic disorder that can involve the central nervous system.We report the case of an adolescent with a history of intraventricular ependymoma resection during childhood and ventriculoperitoneal shunt placement who presented with symptoms of intracranial hypertension.Brain imaging revealed a right intraventricular solid-cystic mass involving the foramen of Monro, associated with subependymal nodules and cortical tubers, suggesting previously undiagnosed TSC.This case emphasizes the importance of recognizing imaging features of TSC in patients presenting with intraventricular tumors to ensure accurate diagnosis and appropriate management.