Astrocytomas are brain tumors that come from the support cells of the brain. These cells are called astrocytes or glial cells (the tumors are also galled gliomas). These are the most common primary brain tumors (tumors that have not spread from elsewhere in the body). There are about 12,000 new cases discovered each year in the U.S. There are a number of different tumors within the group of astrocytomas/gliomas. The first are known as astrocytomas. These grow much more slowly than the next two types. The second type is called anaplastic astrocytoma. This tumor grows more quickly than the astrocytoma and has a worse prognosis. The third type is called glioblastoma multiforme. This type is one of the most malignant tumors of the brain. Previously, astrocytomas were divided into two categories; type I and type II. Anaplastic astrocytoma has been called type III and glioblastoma multiforme has been called type IV. These terms are still in occasional use.
The symptoms of astrocytoma are varied. One of the most common symptoms of these brain tumors is a seizure. Headache can also be present. Other symptoms relate to the location of the tumor within the brain. These symptoms can include weakness or paralysis, unusual sensations, vision problems, problems with language or balance problems. These brain tumors can cause symptoms similar to a stroke but, unlike a stroke which can improve, they tend to be progressive.
While the history and physical examination are always important, the diagnosis of these brain tumors depends on good imaging studies. The best test is an MRI performed both without and with intravenous contrast material. Although CT scans can show some of these brain tumors, the MRI is much more sensitive.
For some cases of astrocytoma, the diagnosis may be in doubt. The MRI might show an abnormality but the actual diagnosis might not be obvious. In some selected cases a course of careful observation with MRI might be recommended. More commonly surgery in the form of either a biopsy or an attempt at removal will be recommended. Unfortunately, these tumors cannot be cured by surgery alone. Surgery is often followed by a course of radiation therapy and possibly chemotherapy. These decisions are usually made by the neurosurgeon in consultation with a radiation oncologist and a medical oncologist. Careful following of the treatment is important, again the best method is with an MRI scan. There are also a number of experimental treatments available for select patients.