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Astrocytoma is one of the most common tumors of the nervous system, belonging to gliomas. It is formed from astrocytes that constitute the supporting tissue of the brain. What are the causes of astrocytoma? What are the symptoms of this glioma and how is it treated?

astrocytoma( astrocytoma ) is a glioma, which in adults is usually located in the supratentorial area, while in children it most often develops in the area of of the brain stem, in the cerebellar hemispheres, less often in the spinal cord. It occurs in every age group, most often in 40-60 years of age, twice as often in men than in women.

There are both benign and malignant forms. The most widely used histological classification system for astrocytomas is the World He alth Organization (WHO) four-tier system. Grade I are histological forms of astrocytomas, occurring mainly in children with a good prognosis. These include juvenile pilocellular astrocytoma, sub-ependymal large cell astrocytoma and hepatoblastoma pleomorphic. Grade II is low grade astrocytoma, grade III is anaplastic astrocytoma, and the last stage IV is glioblastoma multiforme.

Astrocytoma (astrocytoma): symptoms

Symptoms arise as a result of infiltration and destruction of the nerve tissue adjacent to the tumor. They usually build up gradually over a period of weeks, months, or even years, depending on the degree of malignancy of the tumor. The most common symptoms are epilepsy (usually in cases of low grade tumors), symptoms of focal brain damage such as hemiplegia, paralysis of the cranial nerves, speech disorders, and symptoms of increased intracranial pressure characterized by headache, nausea, vomiting and disturbed consciousness. Personality changes that can also result from developing cancer should never be underestimated. The worsening of the patient's clinical condition is of particular importance, which may indicate a haemorrhage in the area of ​​tumor necrosis. Additionally, in patients suffering from epilepsy who are in a stable stage of the disease, the sudden development of disease symptoms may be caused by a malignant transformation of a low-grade tumor.

astrocytoma (astrocytoma): diagnosis

Diagnosis is based on the use of imaging tests such as computed tomography and nuclear magnetic resonance (MRI).

Additionally, the diagnosis of the tumor can be confirmed on the basis of a stereotaxic biopsy or an intraoperative histopathological examination.

They enable the assessment of the nature of the neoplastic tissue, its vascularization and malignancy. For example, in computed tomography, benign astrocytomas are seen as a homogeneous hypodense lesion with vague boundaries. They rarely undergo contrast enhancement and usually do not cause a mass effect. On the other hand, highly malignant astrocytomas have the image of a poorly differentiated tumor. They are characterized by large swelling, heterogeneous structure and enhancement after contrast administration.

Astrocytoma (astrocytoma): treatment

Grade I and II astrocytomas - with favorable tumor location, its complete removal is possible, but due to its diffuse and infiltrating nature, complete surgery can be problematic. Post-operative radiation (radiotherapy) is recommended to prolong survival. If the tumor recurs, the tumor may be re-graded due to less differentiation. The procedure to be followed in such a situation depends on the general condition of the patient, the location of the tumor, the extent of the affected area, the malignancy of the process, and the results of previous treatment.

Grade III and IV astrocytomas - surgical treatment, postoperative irradiation and chemotherapy with various types of drugs are used. In the case of surgical tumors, the aim is to remove the tumor as widely as possible in order to extend the survival time and reduce the resulting neurological deficit.

In the case of recurrence of glioblastoma (stage IV astrocytoma), further management depends on the general condition of the patient and the location of the tumor. Reoperation is possible with favorable tumor localization and good general condition of the patient.

Worth knowing

Astrocytoma: prognosis

Depending on the nature and location of the cancer, the survival time of patients may be very long (many years) or very short (weeks). It is shorter when the brain stem, basal ganglia and thalamus are involved, and longer when the tumor invades the white matter of the hemispheres, the hypothalamus or the cerebellum. The median survival time is approximately 7 years, but only 6% of adults survive for 5 years from diagnosis. It should be remembered that the younger age of the onset of the neoplasm also affects the longer survival of the patient. With relapse, half of the cases progress to more malignant forms (anaplastic astrocytomaor glioblastoma), which is associated with a much worse prognosis.

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