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Fibrillary Astrocytoma


Presentation

  • The unusual radiologic presentation of an optic chiasm fibrillary astrocytoma extending through and expanding the diaphragma sellae in an 8-year-old male is described. The child presented with decreased vision in the right eye.[ncbi.nlm.nih.gov]
  • The most common presenting feature ( 40% of cases) is seizures. This is particularly the case in adults. Headaches are often also present.[radiopaedia.org]
  • Presents full-color images throughout to match the images that you see in practice. Extensive use of "combination" imaging presents a complete picture of how to more precisely locate and target the radiotherapy field.[books.google.com]
Hypersomnia
  • الصفحة 469 - ... insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness; and recurrent thoughts[books.google.com]
Vascular Disease
  • This second volume covers tumors, the phacomatoses, and vascular disease. Volume 1 covers the visual sensory system, the autonomic nervous system, the ocular motor system, the eyelid, facial pain and headache, and nonorganic disease.[books.google.com]
Progressive Loss of Vision
  • loss of vision Double vision Treatment Surgery is standard treatment, usually followed by radiation therapy or chemotherapy.[braintumor.org]
Neck Pain
  • pain or stiffness Visual problems Treatment The doctor will perform tests to determine if it has spread to the spinal cord.[braintumor.org]
Facial Pain
  • Volume 1 covers the visual sensory system, the autonomic nervous system, the ocular motor system, the eyelid, facial pain and headache, and nonorganic disease.[books.google.com]
  • Symptoms include loss of balance, tinnitus, total hearing loss, facial pain or numbness, and headache. Surgery is the standard treatment. Pseudotumor Cerebri This condition is not a brain tumor, but its symptoms mimic a brain tumor.[braintumor.org]
Indecisiveness
  • الصفحة 469 - ... insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness; and recurrent thoughts[books.google.com]
Feeling of Worthlessness
  • الصفحة 469 - ... insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness; and recurrent thoughts[books.google.com]
Hand Tremor
  • My hubby had only hand tremor, nausea, and a single episode of confusion by August 27, 2011. He had diffuse periventricular masses on CT and MRI and stereotactic biopsy on 08/31 finally came back from Mayo on 09/12 as Grade 3 Fibrillary Astrocytome.[csn.cancer.org]
Generalized Seizure
  • The most commonly present symptom is focal or generalized seizure (approximately 80% of patients), followed by focal neurological deficit (30%) (Wessels,... References and Readings Anderson, S. W., Damasion, H., & Tranel, D. (1990).[link.springer.com]

Workup

  • Detection of many of the molecular changes that underlie the development of gliomas and other BT can now be done by immunohistochemistry and is getting into the mainstream of the diagnostic workup of BT.[neuropathology-web.org]
  • […] tumors Other studies EEG may be used to evaluate and monitor epileptiform activity ECG and chest radiographs are indicated to evaluate operative risk CSF studies may be used to rule out other diagnoses (eg, metastasis, lymphoma, medulloblastoma) See Workup[emedicine.com]
Cortical Tubers
  • We present the clinical, computed tomography and magnetic resonance imaging findings of a fibrillary astrocytoma originating from a cortical tuber in a 4-year-old female with TS.[ncbi.nlm.nih.gov]
  • We present the clinical, computed tomography and magnetic resonance imaging findings of a fibrillary astrocytoma originating from a cortical tuber in a 4-year-old female with TS. 2002 S.[karger.com]
  • These children are at risk of developing subependymal giant cell astrocytomas, cortical tubers, and subependymal nodules.[northshore.org]

Treatment

  • Treatment options include surgery, radiotherapy, radiosurgery, and chemotherapy.[en.wikipedia.org]
  • Standard of Care Treatment options depends on the overall health of the person, the type, size, and location of the tumour, if and how far it has spread and previous treatment received.[braintumour.ca]
  • Progressing from fundamental principles through specific treatment strategies for the cancers of each organ system, it also addresses the effects of radiation on normal structures and the avoidance of complications.[books.google.com]
  • Treatment Treatment is controversial. Some tumors may be observed with serial MRI with the assumption that almost all of these tumors will at some point undergo malignant degeneration to a higher grade tumor.[prod.wiki.cns.org]

Prognosis

  • Our findings emphasize the individuality of PA as a distinct clinicopathologic entity with an exceptional prognosis.[ncbi.nlm.nih.gov]
  • Prognosis A prognosis is an estimate of the likely progress of a disease after a diagnosis, based on an average patient group.[braintumour.ca]
  • Complete surgical excision of low-grade tumors is associated with a good prognosis. However, the tumor may recur if the resection is incomplete, in which case further surgery or the use of other therapies may be required.[en.wikipedia.org]
  • MRI T1: isointense to hypointense compared to white matter T2: hyperintense T1 C (Gd): usually little or no enhancement MR spectroscopy: elevated choline:creatine ratio MR perfusion: no elevation of rCBV Treatment and prognosis Treatment depends on clinical[radiopaedia.org]
  • The term “brain tumor” refers to a collection of neoplasms, each with its own biology, prognosis, and treatment; these tumors are better identified as “intracranial neoplasms,” since some do not arise from brain tissue (e.g., meningiomas and lymphomas[intl-content.nejm.org]

Etiology

  • Etiology • mutations affecting p53 • overexpression of platelet-derived growth factor α (PDGF-A) and its receptor • Disruption of tumor suppressor genes • RB and p16/CDKNaA • tumor suppressor on chromosome 19q most common in the low-grade astrocytomas[slideshare.net]
  • The following clinicopathological entities can be distinguished : Pilocytic Astrocytomas (Grade I) Fibrillary Astrocytomas (Grade II) Anaplastic Astrocytomas (Grade III) Glioblastoma Multiforme (Grade IV) Etiology gliomas have been observed following[atlasgeneticsoncology.org]
  • Epidemiology and etiology of gliomas. Acta Neuropathologica. 2005. 109:93-108. [Medline]. C. Bettegowda, M. Sausen, R. J. Leary, I. Kinde, Y. Wang, N. Agrawal, et al. Detection of Circulating Tumor DNA in Early- and Late-Stage Human Malignancies.[emedicine.medscape.com]
  • Etiology of brain tumors in adults. Epidemiol Rev 1995;17:382-414. 13. Simpson JR, Horton J, Scott C, Curran WJ, Rubin P, Fischbach J, et al.[cancerjournal.net]

Epidemiology

  • METHODS: Patients diagnosed with fibrillary, protoplasmic, and gemistocytic astrocytomas were identified through the Surveillance, Epidemiology, and End Results (SEER) database.[ncbi.nlm.nih.gov]
  • Descriptive epidemiology of cerebral gliomas in France. Cancer. 1997 Mar 15. 79(6):1195-202. [Medline]. Nader Pouratian, Ahok Asthagiri, Jay Jagannathan, Mark E Shaffrey, David Schiff.[emedicine.medscape.com]
  • Epidemiology The annual incidence of glioma in the United States is 5.4 cases per 100,000 population. Incidence differences are not significant between the United States and other countries.[emedicine.com]
  • Definition / general Pilocytic means "hair-like," due to long, bipolar processes Most common CNS neoplasm of childhood Better prognosis than diffuse types, particularly if resectable (such as cerebellar tumors) WHO grade I Epidemiology Most common CNS[pathologyoutlines.com]
Sex distribution
Age distribution

Pathophysiology

  • It brings together the pathophysiology of disease with detailed clinical guidance on diagnosis and management for the full range of childhood cancers, including aspects important in optimal supportive care.[books.google.com]
  • Pathophysiology Regional effects of astrocytomas include compression, invasion, and destruction of brain parenchyma.[emedicine.com]
  • Pathophysiology Low-grade astrocytomas are primary tumors (rather than extraaxial or metastatic tumors) of the brain.[emedicine.medscape.com]

Prevention

  • A near-complete resection (less than 10 cc of residual tumor) of low-grade astrocytomas prevents tumor recurrence for longer periods of time.[neurosurgery.ucla.edu]
  • But there is no way to prevent them, and there’s nothing you can do to reduce a child’s risk of developing one.[weillcornellbrainandspine.org]
  • Henry Friedman, head of Oncology at Duke started a trial for the Level 2's to see if it could help in preventing growth and or changing into higher levels.[cancercompass.com]
  • Radiation After surgery, radiation therapy is used to kill leftover tumor cells and try and prevent recurrence.[braintumor.org]
  • TREATMENT — The goals of treatment are to minimize morbidity, prevent tumor enlargement, and prevent transformation of LGG into a more malignant glioma.[aboutcancer.com]

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