Astrocytoma

Astrocytoma Brain Tumor

About Astrocytomas: Symptoms, Treatment and Diagnosis

Glial cells, which are supportive cells that help brain cells (neurons) function are the most common cellular component of the brain. The most common type of glial cell is an astrocyte and an astrocytoma is a type of glial tumor.

More than three quarters of all gliomas are astrocytomas. Other types of gliomas include oligodendroglioma and ependymoma. Pilocytic astrocytomas, the most benign variant, are rare and found almost exclusively in children. On the other end of the spectrum is the glioblastoma—one of the most malignant tumor types found in the body. Treatment options depend on such factors as tumor location, size, and grade.

Diagnosis

• Imaging 
  • Magnetic resonance imaging (MRI) is the most sensitive and best method of detecting brain tumors.
  • Computed tomography (CT) scans can also be used; however, the degree of detail that can be picked up by CT is much less than MRI.
  • Sometimes, other advanced imaging techniques can further help doctors in the diagnosis of astrocytomas.
• Biopsy 
  • Once a mass is suspected by any of the imaging techniques available, the diagnosis needs to be confirmed by obtaining a biopsy of the mass.
  • The biopsy will help differentiate tumor from other types of masses, such as infection. The microscopic structure of the tumor will be important in grading the tumor.
• Tumor grading
  • Important for prognosis and therapy, the tumor grade is an estimate of how aggressive, or malignant, a tumor will behave. Tumors are graded based on the microscopic examination of the tumor specimen. The specimen is scanned to see if any part demonstrates malignant characteristics.
  • For astrocytomas, there are four general grades:
    • Grade 1: Pilocytic Astrocytoma 
    • Grade 2: Low-grade Astrocytoma
    • Grade 3: Anaplastic Astrocytoma
    • Grade 4: Glioblastoma

Treatment

• Surgery 
  • Almost always necessary in order to obtain a piece of tumor tissue for grading, surgery also can be used to remove the mass effect and pressure caused by the tumor.
  • Because glial tumors, including astrocytomas, typically infiltrate surrounding "normal-appearing" brain tissue, surgery is not performed with the intention of obtaining a cure (except for some pilocytic and rare low-grade astrocytomas).
• Radiation
  • Once the diagnosis is confirmed, higher grade astrocytomas usually undergo radiation therapy.
  • Radiation can be administered to the whole brain or it can be relatively focused to a region of the brain. At the same time, or following radiation therapy, one or more chemotherapeutic agents can be used.
  • The UCLA Neuro-Oncology Program has several clinical trials for which patients can be considered.

Outcome

• Several clinical studies demonstrate that the extent of tumor resection correlates with outcome for both low- and high-grade astrocytomas. However, benefit occurs only when more that 98 percent of the tumor visible on MRI was removed.
• Our research indicates that surgeries performed in a standard operative room have a greater probability of leaving behind tumor visible on the post-operative MRI.
• UCLA is one of the few hospitals to have operating rooms equipped with intra-operative MRI scanners. Intra-operative MRI allows our neurosurgeons to determine whether any residual tumor is present prior to closing the wound, enabling more complete resections.

The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. We work in close cooperation with your surgeon or medical doctor with whom you have had initial contact. Together with the surgeon or medical doctor, the Neuro-ICU attending physician and team members direct your family member's care while in the ICU. The Neuro-ICU team consists of the bedside nurses, nurse practitioners, physicians in specialty training (Fellows) and attending physicians. UCLA Neuro ICU Family Guide