- Clinical science
Astrocytoma
Summary
Astrocytomas are neuroepithelial tumors (gliomas) that arise from the supportive tissue of the brain. These tumors are classified by the WHO into four separate grades depending on the extent of abnormality. Astrocytomas initially present with general symptoms including headaches and/or epileptic seizures, which are rapidly replaced by focal symptoms such as progressive paralysis or aphasia. Low-grade astrocytomas are usually localized, slow-growing, and occur predominantly in younger populations (children and adults aged 20–40). Grade IV astrocytomas, on the other hand, are rapidly growing glioblastomas, which are the most common brain tumors in adults aged 50–60. Diagnosis is established based on the patient's clinical history and MRI findings. The treatment for astrocytomas is surgical resection, which may need to be combined with radiotherapy and/or chemotherapy in higher grade tumors. The prognosis is usually poor for higher grade tumors regardless of whether they receive treatment, with a life expectancy of several months (maximum of 2 years). However, low-grade astrocytomas can often be completely cured with effective surgical resection.
Differential diagnosis of astrocytomas
WHO grade | Type | Age | Location | Symptoms | Imaging | Treatment | Prognosis |
---|---|---|---|---|---|---|---|
I |
|
|
|
|
|
| |
|
|
|
|
|
| ||
II |
|
|
|
|
|
| |
III |
|
|
|
|
|
| |
IV |
|
|
|
|
| ||
Variable |
|
|
|
|
|
Astrocytomas nearly always stain positive for glial fibrillary acidic protein (GFAP).
References:[1][2][3][4][5][6][7][8][9][10][11][12][13][14]
Tabular summary of the treatment of astrocytomas
Astrocytoma | Resection | Radiotherapy | Chemotherapy | Palliative |
---|---|---|---|---|
WHO grade 1 | ✓ | |||
WHO grade 2 | ✓ | (✓) | ||
WHO grade 3 | ✓ | ✓ | (✓) | |
WHO grade 4 | ✓ | ✓ | ✓ | ✓ |