Merck Manual

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Renee Gresh

, DO, Nemours A.I. duPont Hospital for Children

Full review/revision Jun 2021 | Modified Sep 2022

Astrocytomas are brain and spinal cord tumors that develop from star-shaped cells (astrocytes) that help nerve cells in the brain (or spinal cord) function. These tumors may be cancerous or not.

  • The cause of astrocytomas is not known.

  • Children may have difficulty walking, weakness, vision changes, vomiting, and headaches.

  • Diagnosis usually involves an imaging test and a biopsy.

  • Treatment options include surgery, chemotherapy, and radiation therapy.

Symptoms of Astrocytomas

Pressure within the skull increases, causing headaches (often when children first awaken), vomiting, and listlessness. Children may lose their coordination and have difficulty walking. Vision may be blurred or lost, and the eyes may bulge or involuntarily jerk in one direction, then drift back (nystagmus).

Astrocytomas in the spinal cord may cause back pain, difficulty walking, and muscle weakness.

Diagnosis of Astrocytomas

  • Magnetic resonance imaging

  • Biopsy

Then doctors must take a sample of tissue from the tumor and examine it under a microscope (biopsy) because treatment is based on how abnormal the tumor cells look (the tumor’s grade). These tumors are typically classified as low grade (for example, juvenile pilocytic astrocytoma) or high grade (for example, glioblastoma). Grades I and II tumors are low grade, and grades III and IV tumors are high grade.

Treatment of Astrocytomas

  • Surgery (if possible)

  • Radiation therapy, chemotherapy, or both

Sometimes, separating the tumor from normal brain tissue is too difficult, or the tumor is inaccessible. In such cases, radiation therapy is used instead. Radiation therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle (linear) accelerator. Radiation preferentially... read more is used in children who are over age 10 years who have a tumor that cannot be removed surgically, that is likely to impair intellectual functioning, or that progresses or returns after surgery. If children are younger than 10 years, chemotherapy Chemotherapy and Other Systemic Cancer Treatments Systemic treatments are those that have effects throughout the body rather than being applied directly to the cancer. Chemotherapy is a form of systemic treatment that uses drugs to kill cancer... read more may be used instead of radiation therapy because radiation therapy can interfere with growth and brain development in young children. Most low-grade astrocytomas can be cured.

High-grade astrocytomas are treated with a combination of surgery (if possible), radiation therapy, and chemotherapy (see Combination Cancer Therapy Combination Cancer Therapy Cancer drugs are most effective when given in combination. The rationale for combination therapy is to use drugs that work by different mechanisms, thereby decreasing the likelihood that resistant... read more ). The outlook is worse for children with a high-grade tumor, in whom the overall survival is only 20 to 30% 3 years after treatment.

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  • American Cancer Society: If Your Child Is Diagnosed With Cancer: A resource for parents and loved ones of a child who has cancer that provides information about how to cope with some of the problems and questions that come up just after a child is diagnosed

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