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Astrocytoma

 

 

Incidence

Astrocytomas account for nearly 50% of all childhood central nervous system (CNS) tumors(1).

  • Peaks in incidence between 5- 6 years and 12 – 13 years

This is a diverse group of tumors, with several different subgroups. The classification of these tumors is evolving:

Tumor cell types are classified depending on the probable cell of origin:

  • Astrocytomas
  • Oligodendroglial tumors (oligodendrocytes).
  • Mixed gliomas (cell types of origin include oligodendrocytes, astrocytes, and ependymal cells).
  • Mixed neuronal-glial tumors.

According to the WHO histologic typing of CNS tumors, childhood astrocytomas and other tumors of glial origin are classified according to clinicopathologic and histologic subtype and are graded (grade I to IV).

Grade 1 and 2 are low grade gliomas

Grade 3 and 4 are high grade gliomas

 

Low grade astrocytomas are the most common CNS  tumor of childhood. 

 

Astrocytomas in childhood:

  • Most frequently occur in the cerebellum
    • usually low grade tumors
  • Cerebral hemispheres and deep midline structures next most frequent sites. 

Neuraxis dissemination is uncommon and prognosis may be excellent if the tumor is low grade and amenable to gross total resection. 

 

Low-grade astrocytomas:

Proportion of pediatric tumors

20%

Proportion of pediatric brain tumors

40%

Median age of pilocytic astrocytomas

5-14 years

Median age of other low-grade astrocytomas

30-40 years

Gender bias

  • Pilocytic astrocytomas: none
  • Low-grade astrocytomas: 1.2: 1 male predilection
  • Anaplastic astrocytomas: 1.9: 1 male predilection

The 2016 WHO criteria began to utilize molecular data in the diagnosis of some tumors because of there is evidence that tumor behavior is driven by common biological alterations.

 

External link: General Information: Childhood Astrocytomas at the NCI

 

 

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