What Is Anaplastic Astrocytoma?

Anaplastic astrocytoma is a rare malignant brain tumor. It develops from astrocyte cells that normally protect nerve cells in the brain and spinal cord.

Anaplastic astrocytomas are grade III astrocytomas. According to the World Health Organization (WHO), there are four grades of astrocytoma. The higher the grade, the faster the cancer cells are reproducing and the more likely the tumor will spread.

Anaplastic Astrocytoma Symptoms

Most symptoms of anaplastic astrocytoma, like other types of brain cancer, are caused by increased pressure in the brain, normally first caused by the growth of the tumor itself.

This buildup of pressure can cause the following symptoms:

• Headaches: These can be a symptom of brain tumors, but those that are tumor-related tend to have distinct characteristics or present with other symptoms such as vomiting. Brain tumor headaches tend to be dull and persistent, with throbbing headaches occurring less often.
• Vomiting: Vomiting is most common in the morning and is often triggered by a sharp movement such as rolling over in bed.
  
• Personality changes: Brain tumors can cause someone to experience personality changes. These changes can include laughing at inappropriate times, having a sudden increased interest in sex, or engaging in risky behaviors. Typical personality traits may also become exaggerated.
• Mood changes: Symptoms of a brain tumor have also been known to mimic depression.
• Drowsiness: The pressure that the tumor puts on the brain can make a person progressively more fatigued, even to the point of unconsciousness.

Symptoms of anaplastic astrocytoma can be specific to the area of the brain where the tumor has developed. Other symptoms may include tingling or burning sensations, balance problems, difficulties communicating, vision problems, and back pain.

Seizures are a common symptom for many brain tumors, but they are less common as an initial symptom in people with anaplastic astrocytoma.

Focal seizures are one kind of seizure seen in brain tumors. Symptoms of focal seizures can include involuntary movements (twitches) of a small part of the body, decreased alertness, or a complete lack of awareness.

Most anaplastic astrocytoma tumors develop slowly and over time. However, in some cases, the tumor develops rapidly, and this can cause symptoms to appear suddenly.

You can have one or more of these symptoms. If you have any of these symptoms, be sure to see your doctor so they won't worsen.

Causes

The specific cause of anaplastic astrocytoma is unknown. However, it is thought that certain genetic, environmental, and lifestyle factors are linked to its development.

Risk factors for anaplastic astrocytoma include:

• Sex: Many epidemiological studies have reported a greater risk of anaplastic astrocytomas among men than women. According to these studies, men are four times more likely to develop astrocytomas than women.
• Race: Studies have consistently found that non-Hispanic whites have the highest number of cases of this type of brain tumor. In addition, there is a high rate of anaplastic astrocytoma in countries with large proportions of individuals of mostly European ancestry.
• Radiation exposure: Exposure to moderate-to-high doses of ionizing radiation (such as in radiotherapy to the head and neck region during childhood to treat leukemia or a brain tumor) increases the risk of some brain tumors. These are more likely to be meningiomas rather than astrocytomas.

One factor linked to a reduced risk of developing anaplastic astrocytomas is having allergies or atopic dermatitis, which includes allergic skin diseases such as eczema. It is not known why this is the case.

Genetics

The majority of anaplastic astrocytoma cases are not inherited, meaning they do not pass from parents to children. However, there are a few rare, inherited disorders linked to an increased risk of anaplastic astrocytoma. They are:

• Li-Fraumeni syndrome: This inherited condition is a defect in a tumor suppressor gene. It increases the risk of several types of cancer.
• Neurofibromatosis type I: In this condition, tumors grow around nerves.
• Tuberous sclerosis: This condition causes tumors in the brain and elsewhere.
• Turcot syndrome: In this condition, benign polyps grow in the intestines in association with a brain tumor.

Scientists have discovered genetic mutations that they believe are linked to anaplastic astrocytoma. Having these genetic mutations means that someone is genetically predisposed to this type of brain cancer. However, that does not mean they will definitely develop anaplastic astrocytoma.

It is thought that the disease won't develop unless it is triggered by other factors such as environmental or lifestyle factors.

Diagnosis

While there are signs and symptoms that may indicate the existence of this type of brain tumor, they are not sufficient for a diagnosis of anaplastic astrocytoma.

An imaging procedure, such as a magnetic resonance imaging (MRI) or computed tomography (CT) scan, will be done. A brain biopsy (the removal and evaluation of the tumor's tissue) is needed to confirm the diagnosis.

The medical team will need to differentiate between anaplastic astrocytoma and other types of brain tumors such as:

• Metastatic tumors
• Lymphomas
• Hemangioblastomas
• Craniopharyngiomas
• Teratomas
• Ependymomas
• Medulloblastomas

Anaplastic astrocytomas also share many symptoms with other, non-brain tumor conditions. These are:

• Meningitis: This is an inflammation of the membranes and fluid that surround the brain and spinal cord. There are two main types of meningitis: viral and bacterial.
  
• Pseudotumor cerebri: This occurs when the pressure within the skull (intracranial pressure) increases for no apparent reason. This increased pressure causes symptoms of a tumor in the brain, but because there is no tumor present, the condition is referred to as a pseudotumor, or false tumor.

Treatment

In most cases, the first-line treatment for anaplastic astrocytoma is surgery, which aims to remove the tumor or as much of it as possible.

Since anaplastic astrocytomas can occur in or near areas of the brain that control bodily functions such as movement, sensation, language, and vision, special measures must be taken in surgery to monitor and protect these functions.

Anaplastic astrocytomas tend to spread into neighboring healthy tissue. This means that it can be difficult to fully remove all cancer cells.

As such, surgery is typically followed by a combination of radiation and chemotherapy treatments, with chemotherapy continuing once radiation treatments end.

Sometimes surgery is not possible if the tumor is in an area where vital functions may be damaged, such as if the tumor is near a major blood vessel or in the brain stem.

The specific treatment plan will be based on a number of factors, including where the tumor is and whether it has spread to other areas, as well as the patient's age and general health.

Your doctor and other members of your health team will help you decide what the best therapies are for you. Your doctor should also go through with you all the potential risks and benefits of each therapy before your treatment plan is made.

Remember to ask lots of questions and bring up any of your concerns.

Prognosis

There are few studies that focus exclusively on patients with anaplastic astrocytoma. A 2018 study looked at 100 patients between 6 and 68 years of age with anaplastic astrocytoma or anaplastic oligodendroglioma. Eighty-four patients had follow-up details and were included for survival analysis. The five-year overall survival rate for anaplastic astrocytoma was 52 percent.

Patients who received adjuvant chemotherapy with the chemotherapeutic agent Temodar (temozolomide) were found to have an increased chance of survival over five years than those who did not.

It is important to note that a number of factors play into survival, including age, the patient's ability to function mentally or physically, and the presence or absence of a number of mutations.

Summary

Anaplastic astrocytoma is a rare form of cancerous brain tumor. Its cause is unknown, but its development is thought to be due to a combination of genetics and environmental factors. A diagnosis of anaplastic astrocytoma can only be made following an imaging procedure, along with a brain biopsy.

Frequent symptoms include headaches, drowsiness, vomiting, and changes in personality or mood. In some cases, symptoms such as seizures, vision problems, or weakness of the arms and legs can also occur.

Surgery is often the initial treatment for anaplastic astrocytoma, usually followed by radiation therapy and chemotherapy used in combination.

A Word From Verywell

Anaplastic astrocytoma is very rare. If you are experiencing the symptoms highlighted above, it is more likely that your condition is not due to this type of cancer.

However, it is important to see a doctor if you experience any new neurological symptoms or if these symptoms continue over time. Remember, a diagnosis can only be made following a thorough clinical evaluation.