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Astrocytomas Defined

Originally published on November 17, 2009
Most recently updated on April 10, 2013

Childhood astrocytomas, also called gliomas, are tumors that form in cells called astrocytes. They can be low-grade or high-grade tumors. The grade of the tumor describes how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. High-grade astrocytomas are fast-growing, malignant tumors. Low-grade astrocytomas are slow-growing tumors that are less likely to be malignant.

Types

Astrocytomas are typically named based on the World Health Organization Scheme

Class I:
Juvenile pilocytic astrocytoma (JPA) is a tumor that grows slowly but can become very large. Pilocytic astrocytoma occurs most often in the cerebellum, cerebrum, optic nerve pathway and brainstem.

**Pilomyxoid astrocytoma (PMA) is a recently defined variant of pilocytic astrocytomas but has different features when looked at under a microscope and behaves more aggressively than pilocytic astrocytomas.

Class II:
Low grade/diffuse astrocytoma may arise in any area of the central nervous system but most commonly develops in the cerebrum, particularly the frontal and temporal lobes. The brain stem and spinal cord are the next most frequently affected sites. These tumors are made up of a moderate number of cells, infiltrative, and often enlarging, which distorts but does not destroy surrounding brain tissue.

Class III:
Anaplastic astrocytoma arises mainly in the cerebral hemispheres. These tumors show increased number of cells, show abnormalities in the nucleus of the cell, marked cell proliferation (fast growing), and a tendency to infiltrate through neighboring tissue.

Class IV:
Glioblastoma is the most frequent tumor of the brain stem in children. These tumors are made up of many cells, with high rates of cell growth and division. Although rapid and extensive invasion of surrounding tissue is common, infiltration to other tissues within or outside the central nervos system is rare.

Symptoms:

Symptoms involved are often due to increased intracranial pressure and depend on location:

- Morning headache                                              
- Frequent nausea and vomiting
- Vision, hearing, and speech problems
- Loss of balance and trouble walking
- Unusual sleepiness
- Unusual changes in personality or behavior
- Seizures
- Increase in the head size (in infants)

Common Treatments:

Astrocytomas are often removed through surgery unless the location of the tumor makes removal unsafe.  Surgery is often followed by radiation or chemotherapy based on how many tumor cells remain, the location of the tumor cells, and the age of the patient. 

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Radiation therapy to the brain must be administered carefully because it can cause growth and developmental delays in children.

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy can either be taken by introducing it to the blood stream or by injecting it directly into the affected tissue.

Clinical Trials are another treatment option in which new treatment methods are being tested to find out if the new cancer treatments are safe and effective or better than the standard treatment. More than 60% of children with cancer are treated as a part of a clinical trial.

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