BACKGROUND: Brain subependymal giant cell astrocytomas (SEGAs) in patients with 
tuberous sclerosis have been reported to respond to everolimus.
METHODS: A 15-year-old male patient with intractable seizures and multiple SEGAs 
of the brain developed leptomeningeal enhancement and multiple metastatic, 
histologically confirmed SEGAs of the spinal cord. He received daily everolimus 
at a dose of 3 mg/m for 6 weeks, which was then increased to 6 mg/m.
RESULTS: Magnetic resonance image of the brain and spine showed significant 
reduction in the size of SEGAs after 6 weeks of treatment. The patient has 
remained free of progression for 24 months. Additional benefits included: 
excellent seizure control, decrease in the size of cardiac rhabdomyomas, and 
improved quality of life.
CONCLUSIONS: We describe a rare case of metastatic SEGA, which was successfully 
treated with everolimus.