Anaplastic astrocytoma

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Anaplastic astrocytoma
Classification and external resources

Micrograph of an anaplastic astrocytoma. H&E stain.

Anaplastic astrocytoma is a WHO grade 3 type of astrocytoma.

Contents

[edit] Symptoms

Initial presenting symptoms most commonly are headache, depressed mental status, focal neurological deficits, and/or seizures.[1] The growth rate and mean interval between onset of symptoms and diagnosis is approximately 1.5–2 years but is highly variable,[1] being intermediate between that of low-grade astrocytomas and glioblastomas.[1] Seizures are less common among patients with anaplastic astrocytomas compared to low-grade lesions.[1]

[edit] Causes

Most high-grade gliomas occur sporadically or without identifiable cause.[2] However, a small proportion (less than 5%) of persons with malignant astrocytoma has a definite or suspected hereditary predisposition.[3] The main hereditary predispositions are mainly neurofibromatosis type I, Li-Fraumeni syndrome, hereditary nonpolyposis colorectal cancer and tuberous sclerosis.[2] Anaplastic astrocytomas have also been associated with previous exposure to vinyl chloride and to high doses of radiation therapy to the brain.[2]

[edit] Treatment

The standard initial treatment is to remove as much of the tumor as possible without worsening neurologic deficits. Radiation therapy has been shown to prolong survival and is a standard component of treatment. There is no proven benefit to adjuvant chemotherapy or supplementing other treatments for this kind of tumor. Although temozolomide is effective for treating recurrent anaplastic astrocytoma, its role as an adjuvant to radiation therapy has not been fully tested.

Quality of life after treatment depends heavily on the area of the brain that housed the tumor. In many cases, patients with anaplastic astrocytoma may experience various types of paralysis, speech impediments, difficulties planning and skewed sensory perception. Most cases of paralysis and speech difficulties can be rehabilitated with speech, occupational, and physical therapy.

[edit] Prognosis

Individuals with grade 3 astrocytoma have a median survival time of 18 months with treatment (radiation and chemotherapy).[4]

[edit] References

  1. ^ a b c d Astrocytoma; Author: Benjamin Kennedy, Columbia University College of Physicians and Surgeons ; Coauthor(s): Jeffrey N Bruce, MD, Edgar M Housepian Professor of Neurological Surgery Research, Professor of Neurological Surgery, Director of Brain Tumor Tissue Bank, Director of Bartoli Brain Tumor Laboratory, Department of Neurosurgery, Columbia University College of Physicians and Surgeons; Jan 23 2009, http://emedicine.medscape.com/article/283453-overview
  2. ^ a b c Children's Hospital Boston > Anaplastic Astrocytoma. Retrieved on August 2010
  3. ^ Malignant astrocytomas By Edward J Dropcho MD. Contributing editor: Dr. Dropcho. Originally released November 11, 1996; last updated December 7, 2009
  4. ^ mdguidelines.com > Astrocytoma Retrieved on Mars 26, 2010
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