Astrocytomas are tumors of the brain and spinal cord. They grow from cells called . Astrocytoma is a type of glioma.
Astrocytoma is the most common type of childhood brain tumor. About half of brain and spinal cord tumors in children are astrocytomas.
Astrocytoma tumors may develop in the cerebellum, cerebrum, brain stem, hypothalamus, visual pathway, or the spinal cord.
Places for astrocytomas to develop include the:
Doctors may refer to an astrocytoma as a low-grade glioma or high-grade glioma. An astrocytoma is classified as or based on how it looks under a microscope.
Treatment for astrocytoma usually includes surgery to remove the tumor. Patients may also have chemotherapy or radiation therapy. Other treatments such as targeted therapy or immunotherapy may be used based on the type of tumor.
The survival rate for pediatric astrocytoma depends on the tumor’s type and location and whether it can be removed by surgery. Your child’s care team is the best source of information about your child’s case.
Some tumors do not cause any symptoms until they become large. Symptoms may be gradual and hard to notice. Other times, symptoms may be severe and develop quickly.
Symptoms of astrocytoma depend on factors such as the child’s age, the tumor’s location and size, and how fast the tumor grows.
Astrocytoma symptoms in children may include:
As the tumor grows, it often blocks the normal flow of (CSF). This causes a buildup of fluid within the brain known as . The fluid increases pressure in the brain. Hydrocephalus may cause some astrocytoma symptoms.
For most children, there is no known cause of astrocytoma.
But certain inherited conditions may increase risk. These include:
Past radiation therapy to the brain also increases risk.
The doctor will do a physical exam and health history. This is to learn about symptoms, general health, past illness, and risk factors.
The doctor will order certain tests.
Tests to diagnose astrocytoma are:
Astrocytomas in children include tumors such as:
Types of glioma include:
Magnetic resonance imaging (MRI) is the main imaging test for astrocytomas.
Astrocytoma tumors are classified by how they look under the microscope. Tumor grades are grades 1–4. The more abnormal the cells look, the higher the grade.
Grade 1 and 2 tumors are low-grade. The cells tend to grow slowly. The prognosis for low-grade astrocytoma is good, especially in children.
Grade 3 and 4 tumors are high-grade. They are aggressive and grow more quickly. The prognosis for high-grade tumors is much worse than for low-grade tumors. But this can depend on the treatments that are available.
Most astrocytomas in children are low-grade.
Low-Grade Tumors (Grade 1 or 2) |
Pilocytic astrocytoma (PA) / Juvenile pilocytic astrocytoma (JPA) Pilomyxoid astrocytoma (PMA) Diffuse astrocytoma / Fibrillary astrocytoma Pleomorphic xanthoastrocytoma (PXA) Subependymal giant cell astrocytoma |
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High-Grade Tumors (Grade 3 or 4) |
Anaplastic astrocytoma (AA) Anaplastic pleomorphic xanthoastrocytoma Glioblastoma / Glioblastoma multiforme (GBM) Diffuse midline glioma (DIPG) |
Pilocytic astrocytoma (or juvenile pilocytic astrocytoma) is the most common pediatric brain tumor. It is a low-grade tumor. It rarely becomes a higher-grade tumor.
Pilocytic astrocytoma is a slow-growing tumor. It seems to grow in phases. In children, these tumors are often in the cerebellum and optic pathway. Surgery is the main treatment for pilocytic astrocytoma. Due to the risk of injuring nearby brain structures during surgery, not all tumors (such as optic pathway gliomas) can be completely removed.
Pilocytic astrocytoma has a 90% survival rate at 10 years in the United States. But infants tend to have a worse prognosis than older children.
Treatment depends on the type of tumor, its location, and whether it has spread or has come back. Aggressive tumors need more intensive treatment.
Doctors also consider the patient’s age. Doctors avoid radiation therapy in very young children. That is because the risk of severe side effects is higher.
Steroid and anti-seizure medicines may help manage symptoms. Some children with hydrocephalus due to astrocytoma may have a shunt placed in the brain to prevent cerebrospinal fluid from building up. A shunt is a small tube that drains fluid from the brain.
The chance of cure depends on the type of tumor and its location. Some low-grade astrocytomas have a survival rate of 95% or higher in the United States. But certain high-grade astrocytomas have a survival rate of 10–30%. Clinical trials may be an option.
Factors that influence chance of cure include:
Recovery and long-term effects of astrocytoma in children depend on the type of tumor and treatments received. Rehabilitation therapy may be needed. Patients should have regular follow-up care, lab tests, and imaging tests.
Low-grade astrocytoma or glioma is often a chronic or long-term disease. Overall survival from low-grade glioma is high. But the tumor often comes back or gets worse over time. Patients may need more treatments. This means the patient is at risk for more complications from the tumor or its treatment.
Sometimes a tumor may show growth on a scan, but the care team recommends observation (watchful waiting) instead of treatment. Good communication and trust among the patient, family, and care team help aid decision making and disease management.
Regular checkups and screenings are important to watch for health problems that can develop years after therapy.
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Reviewed: August 2024
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