Subependymal giant cell astrocytoma is usually seen in children or young adults in the setting of tuberous sclerosis (5% to 15% of cases). It is a well-demarcated, non-infiltrating, solid mass that is composed of epithelioid, gemistocyte-like, and spindled cells. Several gemistocyte-like cells can be seen in this field. The tumor cells may be arranged in perivascular pseudorosettes. The tumor cells share features of glial cells (brightly eosinophilic cytoplasm) and ganglion cells (large vesicular nuclei with prominent nucleoli). Some authors prefer the term subependymal giant cell tumor instead of subependymal giant cell astrocytoma given the mixed glioneuronal features of the tumor cells.