Glioma

Astrocytomas

Astrocytoma glioma brain tumor

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Brainstem glioma (low grade astrocytoma) in a child

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Giant cell astrocytoma

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Astrocytomas are the most common glioma, and can occur in most parts of the brain (and occasionally in the spinal cord). Astrocytomas originate from cells called astrocytes and are most commonly found in the main part of the brain, the cerebrum. People can develop astrocytomas at any age, though they are more common in adults. Astrocytomas in the base of the brain are more common in young people.

Mayo Clinic is highly experienced in treating astrocytomas. Mayo Clinic is ranked No. 1 in Neurology and Neurosurgery by U.S. News & World Report.

Different astrocytomas include:

Low-Grade Astrocytomas

WHO Grade I
World Health Organization (WHO) grade 1 astrocytomas (pilocytic astrocytomas, pleomorphic xanthoastrocytomas, subependymal giant cell astrocytomas, and subependymomas) are uncommon tumors which can often be cured by surgically removing the tumor (resection). Even if the surgeon is not able to remove the entire tumor, it may remain inactive or be successfully treated with radiation.

WHO Grade II
Grade II tumors are defined as being infiltrative gliomas — the tumor cells penetrate into the surrounding normal brain, making a surgical cure more difficult.

Most patients with grade II glioma (oligodendrogliomas, astrocytomas, mixed oligoastrocytomas) are young people who often present with seizures. The median survival varies with the cell type of the tumor. People with oligodendrogliomas have better a prognosis than those with mixed oligoastrocytomas who have better a prognosis than someone with an astrocytoma. Other factors which influence survival include age (younger the better) and performance status (ability to perform tasks of daily living). Due to the infiltrative nature of these tumors, recurrences are relatively common. Depending on the patient, radiation or chemotherapy after surgery is an option.

Most grade II gliomas eventually evolve into more aggressive tumors (grade III or IV) and cannot be cured by surgery and radiation therapy. A practical approach is to remove as much of the abnormal tissue as possible without causing neurologic injury. Research has shown that beginning radiation therapy immediately after diagnosis delays recurrence compared to beginning radiation when there is evidence of tumor growth.

Anaplastic astrocytoma (grade III)
Patients with anaplastic astrocytoma often present with seizures, neurologic deficits, headaches, or changes in mental status. 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. In general, median survival ranges from two to three years. There is no proven benefit to adjuvant chemotherapy (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 tested.

Glioblastoma multiforme (Grade IV)
Glioblastoma multiforme is the most common and most malignant primary brain tumor.

Mayo Publications on Astrocytomas

See a list of publications by Mayo Clinic doctors on astrocytomas on PubMed, a service of the National Library of Medicine.