Astrocytoma (patient information): Difference between revisions

Latest revision as of 17:03, 5 November 2019

Template:Subependymal Giant Cell Astrocytoma (patient information) Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Associate Editor-In-Chief: Jinhui Wu, M.D.; Ammu Susheela, M.D. [2]

Overview

Subependymal giant cell astrocytoma is a rare, benign brain tumor commonly associated with tuberous sclerosis, a genetic disorder. It is seen in about 10-20% of patients with tuberous sclerosis. It is predominantly seen in the pediatric population but can also occur in adults. It arises in the ventricles of the brain and can cause symptoms such as headache, change in vision, nausea, vomiting, though some patients remain asymptomatic. An MRI or CT scan can be used in the diagnosis of subependymal giant cell astrocytoma. Surgery is the main treatment strategy but pharmacological therapy may be used in cases where surgery is contraindicated.

What are the Symptoms of Subependymal Giant Cell Astrocytoma?

Some common symptoms of subependymal giant cell astrocytoma include:

What Causes Subependymal Giant Cell Astrocytoma?

The exact cause of subependymal giant cell astrocytoma is unknown but it is predominantly associated with tuberous sclerosis which is a genetic disorder caused by a mutation in the TSC1 and TSC2 genes.

Who is at Highest Risk?

People with tuberous sclerosis have the highest risk of developing subependymal giant cell astrocytoma

Diagnosis

When patients present with signs and symptoms of subependymal giant cell astrocytoma, along with a thorough history and physical examination, a magnetic resonance imaging (MRI) and computed tomography (CT) scan of the head are used in the diagnosis of subependymal giant cell astrocytoma.

When to Seek Urgent Medical Care?

If acute symptoms such as headache, vomiting, confusion, and blurred vision should develop, or new onset of symptoms, seek urgent care immediately.

Treatment Options

The treatment options for subependymal giant cell astrocytoma include:

Surgery: Surgery is the recommended therapy. It is usually done when patients present with a new set of symptoms, tumor growth is seen on imaging studies, or presents with acute symptoms. In cases that cannot be treated surgically, medical therapy can be used.
Pharmacological therapy: This is used when surgery can't be done, which is when a patient presents with multiple tumors or the tumor has invaded neighboring structures. The preferred medical therapy is mammalian target of rapamycin (mTOR) inhibitors which includes everolimus and rapamycin.

Where to find Medical Care for Subependymal Giant Cell Astrocytoma

Prevention

There are no methods of preventing subependymal giant cell astrocytoma.

What to Expect (Outlook/Prognosis)?

The prognosis is generally poor. A few positive prognostic factors include:

Surgical treatment
Age under 18 years

Possible Complications

Possible complications of subependymal giant cell astrocytoma include:

Bleeding within the tumor
Obstructive hydrocephalus
Stroke
Sudden death

Sources

https://www.nlm.nih.gov/medlineplus/ency/article/000768.htm

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 ==Overview==
-Astrocytoma is a type of [[glioma]] that originates from [[astrocytes]], which support and nourish the [[neuron]]s and help repair the damage when the [[brain]] is injured. Astrocytoma occupies 30% of [[brain]] [[tumor]]s. People with family history of astrocytoma and [[radiation]] exposure are more prone to astrocytoma.  Astrocytoma can cause various neurological symptoms such as [[headache]], [[seizures]], [[drowsiness]] or even [[coma]] and patients are advised to seek urgent medical care for these symptoms. Imaging studies are the best diagnostic modality and [[chemotherapy]], [[radiation]] and [[surgery]] are used to treat the [[disease]]. The [[prognosis]] depends on the staging of the [[disease]].
+Subependymal giant cell astrocytoma is a rare, [[benign]] [[brain tumor]] commonly associated with [[tuberous sclerosis]], a [[genetic disorder]]. It is seen in about 10-20% of patients with [[tuberous sclerosis]]. It is predominantly seen in the pediatric population but can also occur in adults. It arises in the ventricles of the [[brain]] and can cause symptoms such as [[headache]], change in vision, [[nausea]], [[vomiting]], though some patients remain asymptomatic. An [[Magnetic resonance imaging|MRI]] or [[Computed tomography|CT]] scan can be used in the [[diagnosis]] of subependymal giant cell astrocytoma. [[Surgery]] is the main treatment strategy but [[Pharmacological|pharmacological]] therapy may be used in cases where [[surgery]] is contraindicated.
-==What are the symptoms of subependymal giant cell astrocytoma?==
+==What are the Symptoms of Subependymal Giant Cell Astrocytoma?==
-Usual symptoms include [[headache]], [[nausea]] and [[vomiting]], [[seizure]], [[hydrocephalus]],  [[weakness]], or [[numbness]] in the extremities, [[blurred vision]]
+Some common [[symptoms]] of subependymal giant cell astrocytoma include:
-balance problems, personality or behavior changes, [[seizures]], [[drowsiness]] or even [[coma]].
+*[[Headache]]
+*[[Vomiting]]
+*[[Nausea]]
+*[[Blurred vision]]
+*[[Seizure]]
+*[[Personality changes|Change in personality/behavior]]
+*[[Memory loss]]
-==What causes astrocytoma?==
+==What Causes Subependymal Giant Cell Astrocytoma?==
-[[Radiation]] causing genetic mutation is suspected to be the cause of astrocytoma.
+The exact cause of subependymal giant cell astrocytoma is unknown but it is predominantly associated with [[tuberous sclerosis]] which is a [[genetic disorder]] caused by a [[mutation]] in the [[TSC1]] and [[TSC2]] [[genes]].
-==Who is at highest risk?==
+==Who is at Highest Risk?==
-People with radiation exposure, family history of [[neurofibromatosis type 1]] (NF1), [[neurofibromatosis type 2]] (NF2), [[tuberous sclerosis]], [[Von Hippel-Lindau disease]], [[Li-Fraumeni syndrome]], [[gorlin syndrome]], [[turcot syndrome]] and [[cowden syndrome]].
+People with [[tuberous sclerosis]] have the highest risk of developing subependymal giant cell astrocytoma
 ==Diagnosis==
-Along with a thorough history and physical examination, imaging studies such as head [[magnetic resonance imaging]] (MRI), [[computed tomography]] (CT) scan, [[positron emission tomography]] (PET) scan, [[chest x-ray]] and [[angiogram]] are used for the diagnosis of astrocytoma. [[Blood]] and [[urine]] tests, [[lumbar puncture]] ([[spinal tap]]), surgical or open [[biopsy]] ([[craniotomy]]) are also conducted.
+When patients present with signs and symptoms of subependymal giant cell astrocytoma, along with a thorough [[History and Physical examination|history and physical examination]], a [[Magnetic resonance imaging|magnetic resonance imaging (MRI)]] and [[Computed tomography|computed tomography (CT) scan]] of the head are used in the [[diagnosis]] of subependymal giant cell astrocytoma.
-==When to seek urgent medical care?==
+==When to Seek Urgent Medical Care?==
-* Call a health care provider if a child develops [[headache]]s that do not go away or other symptoms of a [[brain]] tumor.
+If acute [[Symptom|symptoms]] such as [[headache]], [[vomiting]], [[confusion]], and [[blurred vision]] should develop, or new onset of [[Symptom|symptoms]], seek urgent care immediately.
-* Go to the emergency room if a child develops any of the following:
-:* Physical weakness
-:* Change in behavior
-:* [[Vomiting]]
-:* [[Drowsiness]]
-:* Severe [[headache]] of unknown cause
-:* [[Seizure]] of unknown cause
-:* [[Vision]] changes
-:* [[Speech]] changes
-==Treatment options==
+==Treatment Options==
-Treatments include [[surgery]], [[radiation therapy]], [[chemotherapy]], [[gene therapy]], or a combination of them. Because most [[astrocytomas]] can spread widely throughout the normal [[brain]] tissue, it may be very hard to remove by [[surgery]]. If you have completed treatment, your doctors will still want to watch you closely. It’s very important to keep all follow-up appointments. During these visits, your doctors will ask about symptoms, examine you, and may order lab tests or imaging tests such as [[MRI]] scans to look for a recurrence of the tumor. In some cases, some of the tumor may still be left behind after treatment. Once you have recovered from treatment, your doctors will try to determine if damage was done to the [[brain]] or other areas. Several types of doctors and other health professionals might help you recover from the after effects of the disease.
+The treatment options for subependymal giant cell astrocytoma include:
+*[[Surgery]]: [[Surgery]] is the recommended therapy. It is usually done when patients present with a new set of [[Symptom|symptoms]], [[tumor]] growth is seen on imaging studies, or presents with acute [[symptoms]]. In cases that cannot be treated [[Surgery|surgically]], medical therapy can be used.
+*[[Pharmacological]] therapy: This is used when [[surgery]] can't be done, which is when a patient presents with multiple [[Tumor|tumors]] or the [[tumor]] has invaded neighboring structures. The preferred medical therapy is mammalian target of rapamycin (mTOR) inhibitors which includes [[everolimus]] and [[rapamycin]].
-==Where to find medical care for astrocytoma?==
+==Where to find Medical Care for Subependymal Giant Cell Astrocytoma==
-[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|astrocytoma}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating astrocytoma]
+==Prevention==
+There are no methods of preventing subependymal giant cell astrocytoma.
-==What to expect (Outlook/Prognosis)?==
+==What to Expect (Outlook/Prognosis)?==
-* The prognosis (chance of recovery) and treatment options depend on the following:
+The [[prognosis]] is generally poor. A few positive prognostic factors include:
-:* Where the astrocytoma formed in the [[CNS]] and if it has spread.
+*[[Surgery|Surgical treatment]]
-:* Whether [[cancer]] cells remain after [[surgery]].
+*Age under 18 years
-:* The type and grade of astrocytoma.
-:* Whether the child has [[NF1]].
-:* Whether there are certain changes in the [[genes]].
-:* The child’s age.
-:* Whether the astrocytoma has just been diagnosed or has recurred (come back).
-:* For recurrent astrocytoma, prognosis and treatment depend on how much time passed from the time treatment ended to the time the astrocytoma recurred.
-==Related Chapters==
-*[[Glioma (patient information)]]
-==Source==
+==Possible Complications==
+Possible complications of subependymal giant cell astrocytoma include:
+*Bleeding within the [[tumor]]
+*[[Obstructive hydrocephalus]]
+*[[Stroke]]
+*Sudden death
+==Sources==
 * https://www.nlm.nih.gov/medlineplus/ency/article/000768.htm