1. Anaplastic Astrocytoma Versus Dmg 4
2. Prognosis For Anaplastic Astrocytoma
3. Anaplastic Astrocytoma Brain Tumor Prognosis
4. Anaplastic Astrocytoma Versus Dmg C

Anaplastic astrocytoma is a rare WHO grade III type of astrocytoma, which is a type of cancer of the brain. In the United States, the annual incidence rate for Anaplastic astrocytoma is 0.44 per 100,000 people ^[1]

Signs and symptoms[edit]

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

Causes[edit]

• Anaplastic astrocytoma is a rare WHO grade III type of astrocytoma, which is a type of cancer of the brain.In the United States, the annual incidence rate for Anaplastic astrocytoma is 0.44 per 100,000 people.
• My daughter, who is college age, has an inoperable anaplastic astrocytoma grade 3. She was diagnosed 9/7/01 and went through chemo (Temodar)for a year and radiation treatments for 6 weeks. There has been no new growth and she has been told that she could go decades without it starting to grow again. She always ate a semi healthy diet - no.
• The slowest-growing type of astrocytoma in adult patients is a Grade II astrocytoma. These tumors can grow large and have the potential to damage adjacent structures and/or cause symptoms. Grade III – Anaplastic Astrocytoma. The next grade of astrocytoma, Grade III, indicates a tumor is behaving more aggressively.

One study compared eflornithine’s antitumor activity alone versus in combination with mitoguazone to treat patients with recurrent or progressive glioblastoma multiforme (GBM), as well as nonglioblastoma anaplastic gliomas. 4 Out of a total of 80 patients (36 with GBM and 44 with anaplastic glioma), antitumor activity was seen in 45% of the.

Most high-grade gliomas occur sporadically or without identifiable cause.^[3] However, a small proportion (less than 5%) of persons with malignant astrocytoma has a definite or suspected hereditary predisposition.^[4] The main hereditary predispositions are mainly neurofibromatosis type I, Li-Fraumeni syndrome, hereditary nonpolyposis colorectal cancer and tuberous sclerosis.^[3] Anaplastic astrocytomas have also been associated with previous exposure to vinyl chloride and to high doses of radiation therapy to the brain.^[3]

Pathology[edit]

Anaplastic astrocytomas fall under the category of high grade gliomas (WHO grade III-IV), which are pathologically undifferentiated gliomas that carry a poor clinical prognosis. Unlike glioblastomas (WHO grade IV), anaplastic astrocytomas lack vascular proliferation and necrosis on pathologic evaluation.^[5] Compared to grade II tumors, anaplastic astrocytomas are more cellular, demonstrate more atypia, and mitoses are seen.

Treatment[edit]

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, physical, and vision therapy.

Prognosis[edit]

The age-standardized 5-year relative survival rate is 23.6%.^[6] Patients with this tumor are 46 times more likely to die than matched members of the general population.^[6] It is important to note that prognosis across age groups is different especially during the first three years post-diagnosis. When the elderly population is compared with young adults, the excess hazard ratio (a hazard ratio that is corrected for differences in mortality across age groups) decreases from 10.15 to 1.85 at 1 to 3 years, meaning that the elderly population are much more likely to die in the first year post-diagnosis when compared to young adults (aged 15 to 40), but after three years, this difference is reduced markedly.^[6] Typical median survival for anaplastic astrocytoma is 2–3 years. Secondary progression to glioblastoma multiforme is common. Radiation, younger age, female sex, treatment after 2000, and surgery were associated with improved survival in AA patients.^[7]

References[edit]

1. ^'Malignant astrocytomas - Epidemiology'.
2. ^ ^abcdAstrocytoma at eMedicine
3. ^ ^abcChildren's Hospital Boston > Anaplastic Astrocytoma.Archived 2010-07-06 at the Wayback Machine Retrieved on August 2010
4. ^Malignant astrocytomas By Edward J Dropcho MD. Contributing editor: Dr. Dropcho. Originally released November 11, 1996; last updated December 7, 2009
5. ^'Anaplastic astrocytoma'.
6. ^ ^abcSmoll NR, Hamilton B (2014). 'Incidence and relative survival of anaplastic astrocytomas'. Neuro-Oncology. 0 (10): 1–8. doi:10.1093/neuonc/nou053. PMC4165416. PMID24723565.
7. ^Nuño M, Birch K, Mukherjee D, Sarmiento JM, Black KL, Patil CG. Survival and prognostic factors of anaplastic gliomas. Neurosurgery. 2013 Sep;73(3):458-65. doi: 10.1227/01.neu.0000431477.02408.5e. PubMed PMID23719055.

External links[edit]

A pilocytic astrocytoma (and its variant juvenile pilomyxoid astrocytoma) is a brain tumor that occurs more often in children and young adults (in the first 20 years of life). They usually arise in the cerebellum, near the brainstem, in the hypothalamic region, or the optic chiasm, but they may occur in any area where astrocytes are present, including the cerebral hemispheres and the spinal cord. These tumors are usually slow growing and benign.^[1] The neoplasms are associated with the formation of one or more cysts, and can become very large.

Pilocytic astrocytomas are often cystic, and, if solid, tend to be well-circumscribed. They are characteristically easily seen on computed tomography (CT scans) and magnetic resonance imaging (MRI).

Juvenile pilocytic astrocytoma is associated with neurofibromatosis type 1 (NF1), and optic gliomas are among the most frequently encountered tumors in patients with this disorder. The majority of pilocytic astrocytomas have a unique KIAA1549L-BRAF fusion gene.^[2][3]

• 2Diagnosis
• 3Treatment

Symptoms[edit]

Children affected by pilocytic astrocytoma can present with different symptoms that might include failure to thrive (lack of appropriate weight gain/ weight loss), headache, nausea, vomiting, irritability, torticollis (tilt neck or wry neck), difficulty to coordinate movements, and visual complaints (including nystagmus). The complaints may vary depending on the location and size of the neoplasm. The most common symptoms are associated with increased intracranial pressure due to the size of the neoplasm.^{[citation needed]}

Anaplastic Astrocytoma Versus Dmg 4

Diagnosis[edit]

Usually – depending on the interview of the patient and after a clinical exam which includes a neurological exam and an ophthalmological exam – a CT scan and/or an MRI scan will be performed. A special dye may be injected into a vein before these scans to provide contrast and make tumors easier to identify. The neoplasm will be clearly visible.

If a tumor is found, it will be necessary for a neurosurgeon to perform a biopsy of it. This simply involves the removal of a small amount of tumorous tissue, which is then sent to a (neuro)pathologist for examination and staging.^[4] The biopsy may take place before surgical removal of the tumor, or the sample may be taken during surgery.

Visual aspect[edit]

Microscopically, an astrocytoma is a mass that looks well-circumscribed and has a large cyst. The neoplasm may also be solid.

Under the microscope, the tumor is seen to be composed of bipolar cells with long 'hairlike' GFAP-positive processes, giving the designation 'pilocytic' (that is, made up of cells that look like fibers when viewed under a microscope^[5]). Some pilocytic astrocytomas may be more fibrillary and dense in composition. There is often presence of Rosenthal fibers,^[6]eosinophilic granular bodies, and microcysts. Myxoid foci and oligodendroglioma-like cells may also be present, though non-specific. Long-standing lesions may show hemosiderin-laden macrophages and calcifications.

Treatment[edit]

The most common form of treatment is having the tumor surgically removed. However, total resection is often not possible. The location could prohibit access to the neoplasm and lead to incomplete or no resection at all. Removal of the tumor will generally allow functional survival for many years. In particular for pilocytic astrocytomas (commonly indolent bodies that may permit normal neurologic function), surgeons may decide to monitor the neoplasm's evolution and postpone surgical intervention for some time. However, left unattended these tumors may eventually undergo neoplastic transformation.

If surgery is not possible, recommendations such as chemotherapy or radiation may be suggested. However, side effects from these treatments can be extensive and long term.^[7]

Side effects[edit]

Children with cerebellar pilocytic astrocytoma may experience side effects related to the tumor itself depending on the location and related to the treatment.

• Symptoms related to increased pressure in the brain often disappear after surgical removal of the tumor.
• Effects on coordination and balance improve and might progressively (to completely) disappear as recovery progresses.
• Steroid treatment is often used to control tissue swelling that may occur pre- and post-operatively.
• Children can also suffer long term side effects due to the type of treatment they may receive.

Expected outcome after treatment[edit]

Grade I pilocytic astrocytoma and cerebellar gliomas are not associated with recurrence after complete resection. Grade II astrocytomas and cerebellar gliomas are more likely to recur after surgical removal. Pilomyxoid astrocytomas may behave more aggressively than classic pilocytic astrocytoma.

After complete surgical removal, in cases of progressive/recurrent disease or when maximal surgical removal has been achieved, chemotherapy and/or radiation therapy will be considered by the medical team.^{[citation needed]}

Occurrence[edit]

According to a Dutch source, juvenile pilocytic astrocytoma occurs at a rate of 2 in 100,000 people. Most affected are children ages 5–14 years.^[8] According to the National Cancer Institute, more than 80% of astrocytomas located in the cerebellum are low grade (pilocytic grade I) and often cystic; most of the remainder are diffuse grade II astrocytomas.^[9]

Tumors of the optic pathway account for 3.6-6% of pediatric brain tumors, 60% of which are juvenile pilocytic astrocytomas. Astrocytomas account for 50% of pediatric primary central nervous system tumors. About 80-85% of cerebellar astrocytomas are juvenile pilocytic astrocytomas.^[10]

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Recent genetic studies of pilocytic astrocytomas show that some sporadic cases have gain in chromosome 7q34 involving the BRAF locus.^[11]

Prognosis For Anaplastic Astrocytoma

Additional images[edit]

• Histopathology of pilocytic astrocytoma (grade I WHO). H&E stain. Original magnification 200x.

• Histopathology of Rosenthal-fibres. H&E staining showing these elongated eosinophilic structures in a case of pilocytic astrocytoma. Magnification 400x

References[edit]

1. ^Huang H, Hara A, Homma T, Yonekawa Y, Ohgaki H (October 2005). 'Altered expression of immune defense genes in pilocytic astrocytomas'. J. Neuropathol. Exp. Neurol. 64 (10): 891–901. doi:10.1097/01.jnen.0000183345.19447.8e. PMID16215461.
2. ^Jones, D. T.; Kocialkowski, S; Liu, L; Pearson, D. M.; Bäcklund, L. M.; Ichimura, K; Collins, V. P. (2008). 'Tandem duplication producing a novel oncogenic BRAF fusion gene defines the majority of pilocytic astrocytomas'. Cancer Research. 68 (21): 8673–7. doi:10.1158/0008-5472.CAN-08-2097. PMC2577184. PMID18974108.
3. ^Sadighi, Z; Slopis, J (2013). 'Pilocytic astrocytoma: A disease with evolving molecular heterogeneity'. Journal of Child Neurology. 28 (5): 625–32. doi:10.1177/0883073813476141. PMID23439714.
4. ^http://www.cap.org/apps/docs/reference/myBiopsy/pilocytic_astrocytoma.html^{[full citation needed]}
5. ^National Cancer Institute > Dictionary of Cancer Terms > pilocytic Retrieved on July 16, 2010
6. ^Wippold FJ, Perry A, Lennerz J (May 2006). 'Neuropathology for the neuroradiologist: Rosenthal fibers'. AJNR Am J Neuroradiol. 27 (5): 958–61. PMID16687524.
7. ^'Juvenile Pilocytic Astrocytoma - NORD (National Organization for Rare Disorders)'. NORD (National Organization for Rare Disorders). Retrieved 2017-12-09.
8. ^http://www.hersentumor.nl^{[full citation needed]}
9. ^'Childhood Astrocytomas Treatment'. National Cancer Institute. 2009-08-21. Retrieved 2017-12-09.
10. ^Imaging in Juvenile Pilocytic Astrocytoma at eMedicine
11. ^Bar et al., 2008^{[page needed][full citation needed]}

External links[edit]

Anaplastic Astrocytoma Brain Tumor Prognosis

Anaplastic Astrocytoma Versus Dmg C