The central nervous system is made up of the brain and spinal cord. Astrocytomas are central nervous system tumors that develop from star-shaped cells (astrocytes) that help nerve cells in the brain or spinal cord function. These tumors may be cancerous (malignant) 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.
Astrocytomas are the most common central nervous system tumors in children, accounting for about 40% of cases. These tumors are usually diagnosed between ages 5 years and 9 years. These tumors can occur anywhere in the brain or spinal cord but are most common in the cerebellum (the area near the base of the brain that coordinates the body’s movements).
Astrocytomas are a type of brain tumor called a glioma.
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. The child may have nystagmus, in which the eyes involuntarily jerk in one direction, then drift back.
Astrocytomas in the spinal cord may cause back pain, difficulty walking, numbness, and muscle weakness.
Diagnosis of Astrocytomas
Magnetic resonance imaging
Biopsy
Magnetic resonance imaging (MRI) is usually done. Before MRI is done, a contrast agent is injected into a vein (intravenously). Contrast agents are substances that make organs and other structures clearer to see on imaging tests. If MRI is unavailable, computed tomography (CT) is used, but it provides less detail.
Then doctors usually 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). Astrocytomas are typically classified as low grade (for example, pilocytic astrocytoma) or high grade (for example, anaplastic astrocytoma). Grades 1 and 2 tumors are low grade, and grades 3 and 4 tumors are high grade.
Treatment of Astrocytomas
Surgery (if possible)
Radiation therapy, chemotherapy, or both
(See also Cancer Treatment Principles.)
Most low-grade astrocytomas are surgically removed. If the astrocytoma is completely removed, children may not need any other treatment.
Sometimes, surgery is not possible. Chemotherapy is used in children who have a tumor that cannot be removed surgically or that progresses or returns after surgery.
Radiation therapy is rarely used to treat low-grade astrocytomas because it can interfere with growth and brain development.
Most low-grade astrocytomas can be treated successfully, and children can be long-term survivors.
High-grade astrocytomas are treated with a combination of surgery (if possible) and radiation therapy (see Combination Cancer Therapy). The role of chemotherapy is not clear.
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 English-language resource 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
