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Astrocytoma
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Intramedullary glioma
              • Definitions

                • Primary neoplasm of astrocytic origin within spinal cord (SC)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nonvascular Interventions

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Ahmed R et al: Long-term disease and neurological outcomes in patients with pediatric intramedullary spinal cord tumors. J Neurosurg Pediatr. 13(6):600-12, 2014
                                                  2. Kim DH et al: Differentiation between intramedullary spinal ependymoma and astrocytoma: comparative MRI analysis. Clin Radiol. 69(1):29-35, 2014
                                                  3. Heo DH et al: A histopathological diagnostic marker for human spinal astrocytoma: expression of glial fibrillary acidic protein-δ. J Neurooncol. 108(1):45-52, 2012
                                                  4. Tomura N et al: PET findings of intramedullary tumors of the spinal cord using [18F] FDG and [11C] methionine. AJNR Am J Neuroradiol. Epub ahead of print, 2012
                                                  5. Colnat-Coulbois S et al: Management of intramedullary cystic pilocytic astrocytoma with rhenium-186 intracavitary irradiation: case report. Neurosurgery. 66(5):E1023-4; discussion E1024, 2010
                                                  6. Ewelt C et al: Cordectomy as final treatment option for diffuse intramedullary malignant glioma using 5-ALA fluorescence-guided resection. Clin Neurol Neurosurg. 112(4):357-61, 2010
                                                  7. Horger M et al: Spinal pilocytic astrocytoma: MR imaging findings at first presentation and following surgery. Eur J Radiol. Epub ahead of print, 2010
                                                  8. Jeong SM et al: Intracranial dissemination from spinal cord anaplastic astrocytoma. J Korean Neurosurg Soc. 47(1):68-70, 2010
                                                  9. Paraskevopoulos D et al: Pilomyxoid astrocytoma of the cervical spinal cord in a child with rapid progression into glioblastoma: case report and literature review. Childs Nerv Syst. Epub ahead of print, 2010
                                                  10. Raco A et al: High-grade intramedullary astrocytomas: 30 years' experience at the Neurosurgery Department of the University of Rome "Sapienza". J Neurosurg Spine. 12(2):144-53, 2010
                                                  11. Seo HS et al: Nonenhancing intramedullary astrocytomas and other MR imaging features: a retrospective study and systematic review. AJNR Am J Neuroradiol. 31(3):498-503, 2010
                                                  12. Harrop JS et al: Primary intramedullary tumors of the spinal cord. Spine (Phila Pa 1976). 34(22 Suppl):S69-77, 2009
                                                  13. Komotar RJ et al: Magnetic resonance imaging characteristics of pilomyxoid astrocytoma. Neurol Res. 30(9):945-51, 2008
                                                  14. Nakamura M et al: Pleomorphic xanthoastrocytoma of the spinal cord. Case report. J Neurosurg Spine. 5(1):72-5, 2006
                                                  15. Arslanoglu A et al: MR imaging characteristics of pilomyxoid astrocytomas. AJNR Am J Neuroradiol. 24(9):1906-8, 2003
                                                  16. Saito R et al: Symptomatic spinal dissemination of malignant astrocytoma. J Neurooncol. 61(3):227-35, 2003
                                                  17. Santi M et al: Spinal cord malignant astrocytomas. Clinicopathologic features in 36 cases. Cancer. 98(3):554-61, 2003
                                                  18. Sun B et al: MRI features of intramedullary spinal cord ependymomas. J Neuroimaging. 13(4):346-51, 2003
                                                  19. Brotchi J: Intrinsic spinal cord tumor resection. Neurosurgery. 50(5):1059-63, 2002
                                                  20. Kim MS et al: Intramedullary spinal cord astrocytoma in adults: postoperative outcome. J Neurooncol. 52(1):85-94, 2001
                                                  21. Constantini S et al: Radical excision of intramedullary spinal cord tumors: surgical morbidity and long-term follow-up evaluation in 164 children and young adults. J Neurosurg. 93(2 Suppl):183-93, 2000
                                                  22. Houten JK et al: Pediatric intramedullary spinal cord tumors: special considerations. J Neurooncol. 47(3):225-30, 2000
                                                  23. Houten JK et al: Spinal cord astrocytomas: presentation, management and outcome. J Neurooncol. 47(3):219-24, 2000
                                                  24. Lowe GM: Magnetic resonance imaging of intramedullary spinal cord tumors. J Neurooncol. 47(3):195-210, 2000
                                                  25. Miller DC: Surgical pathology of intramedullary spinal cord neoplasms. J Neurooncol. 47(3):189-94, 2000
                                                  26. Nishio S et al: Spinal cord gliomas: management and outcome with reference to adjuvant therapy. J Clin Neurosci. 7(1):20-3, 2000
                                                  27. Strik HM et al: A case of spinal glioblastoma multiforme: immunohistochemical study and review of the literature. J Neurooncol. 50(3):239-43, 2000
                                                  28. Baleriaux DL: Spinal cord tumors. Eur Radiol. 9(7):1252-8, 1999
                                                  29. Bourgouin PM et al: A pattern approach to the differential diagnosis of intramedullary spinal cord lesions on MR imaging. AJR Am J Roentgenol. 170(6):1645-9, 1998
                                                  30. Squires LA et al: Diffuse infiltrating astrocytoma of the cervicomedullary region: clinicopathologic entity. Pediatr Neurosurg. 27(3):153-9, 1997
                                                  31. Minehan KJ et al: Spinal cord astrocytoma: pathological and treatment considerations. J Neurosurg. 83(4):590-5, 1995
                                                  32. Nemoto Y et al: Intramedullary spinal cord tumors: significance of associated hemorrhage at MR imaging. Radiology. 182(3):793-6, 1992
                                                  33. Li MH et al: MR imaging of spinal intramedullary tumors. Acta Radiol. 32(6):505-13, 1991
                                                  34. Scotti G et al: Magnetic resonance diagnosis of intramedullary tumors of the spinal cord. Neuroradiology. 29(2):130-5, 1987
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Synonyms

                                                                • Intramedullary glioma
                                                              • Definitions

                                                                • Primary neoplasm of astrocytic origin within spinal cord (SC)

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Nonvascular Interventions

                                                                        • Nuclear Medicine Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Staging, Grading, & Classification

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Consider

                                                                                                • Image Interpretation Pearls

                                                                                                  Selected References

                                                                                                  1. Ahmed R et al: Long-term disease and neurological outcomes in patients with pediatric intramedullary spinal cord tumors. J Neurosurg Pediatr. 13(6):600-12, 2014
                                                                                                  2. Kim DH et al: Differentiation between intramedullary spinal ependymoma and astrocytoma: comparative MRI analysis. Clin Radiol. 69(1):29-35, 2014
                                                                                                  3. Heo DH et al: A histopathological diagnostic marker for human spinal astrocytoma: expression of glial fibrillary acidic protein-δ. J Neurooncol. 108(1):45-52, 2012
                                                                                                  4. Tomura N et al: PET findings of intramedullary tumors of the spinal cord using [18F] FDG and [11C] methionine. AJNR Am J Neuroradiol. Epub ahead of print, 2012
                                                                                                  5. Colnat-Coulbois S et al: Management of intramedullary cystic pilocytic astrocytoma with rhenium-186 intracavitary irradiation: case report. Neurosurgery. 66(5):E1023-4; discussion E1024, 2010
                                                                                                  6. Ewelt C et al: Cordectomy as final treatment option for diffuse intramedullary malignant glioma using 5-ALA fluorescence-guided resection. Clin Neurol Neurosurg. 112(4):357-61, 2010
                                                                                                  7. Horger M et al: Spinal pilocytic astrocytoma: MR imaging findings at first presentation and following surgery. Eur J Radiol. Epub ahead of print, 2010
                                                                                                  8. Jeong SM et al: Intracranial dissemination from spinal cord anaplastic astrocytoma. J Korean Neurosurg Soc. 47(1):68-70, 2010
                                                                                                  9. Paraskevopoulos D et al: Pilomyxoid astrocytoma of the cervical spinal cord in a child with rapid progression into glioblastoma: case report and literature review. Childs Nerv Syst. Epub ahead of print, 2010
                                                                                                  10. Raco A et al: High-grade intramedullary astrocytomas: 30 years' experience at the Neurosurgery Department of the University of Rome "Sapienza". J Neurosurg Spine. 12(2):144-53, 2010
                                                                                                  11. Seo HS et al: Nonenhancing intramedullary astrocytomas and other MR imaging features: a retrospective study and systematic review. AJNR Am J Neuroradiol. 31(3):498-503, 2010
                                                                                                  12. Harrop JS et al: Primary intramedullary tumors of the spinal cord. Spine (Phila Pa 1976). 34(22 Suppl):S69-77, 2009
                                                                                                  13. Komotar RJ et al: Magnetic resonance imaging characteristics of pilomyxoid astrocytoma. Neurol Res. 30(9):945-51, 2008
                                                                                                  14. Nakamura M et al: Pleomorphic xanthoastrocytoma of the spinal cord. Case report. J Neurosurg Spine. 5(1):72-5, 2006
                                                                                                  15. Arslanoglu A et al: MR imaging characteristics of pilomyxoid astrocytomas. AJNR Am J Neuroradiol. 24(9):1906-8, 2003
                                                                                                  16. Saito R et al: Symptomatic spinal dissemination of malignant astrocytoma. J Neurooncol. 61(3):227-35, 2003
                                                                                                  17. Santi M et al: Spinal cord malignant astrocytomas. Clinicopathologic features in 36 cases. Cancer. 98(3):554-61, 2003
                                                                                                  18. Sun B et al: MRI features of intramedullary spinal cord ependymomas. J Neuroimaging. 13(4):346-51, 2003
                                                                                                  19. Brotchi J: Intrinsic spinal cord tumor resection. Neurosurgery. 50(5):1059-63, 2002
                                                                                                  20. Kim MS et al: Intramedullary spinal cord astrocytoma in adults: postoperative outcome. J Neurooncol. 52(1):85-94, 2001
                                                                                                  21. Constantini S et al: Radical excision of intramedullary spinal cord tumors: surgical morbidity and long-term follow-up evaluation in 164 children and young adults. J Neurosurg. 93(2 Suppl):183-93, 2000
                                                                                                  22. Houten JK et al: Pediatric intramedullary spinal cord tumors: special considerations. J Neurooncol. 47(3):225-30, 2000
                                                                                                  23. Houten JK et al: Spinal cord astrocytomas: presentation, management and outcome. J Neurooncol. 47(3):219-24, 2000
                                                                                                  24. Lowe GM: Magnetic resonance imaging of intramedullary spinal cord tumors. J Neurooncol. 47(3):195-210, 2000
                                                                                                  25. Miller DC: Surgical pathology of intramedullary spinal cord neoplasms. J Neurooncol. 47(3):189-94, 2000
                                                                                                  26. Nishio S et al: Spinal cord gliomas: management and outcome with reference to adjuvant therapy. J Clin Neurosci. 7(1):20-3, 2000
                                                                                                  27. Strik HM et al: A case of spinal glioblastoma multiforme: immunohistochemical study and review of the literature. J Neurooncol. 50(3):239-43, 2000
                                                                                                  28. Baleriaux DL: Spinal cord tumors. Eur Radiol. 9(7):1252-8, 1999
                                                                                                  29. Bourgouin PM et al: A pattern approach to the differential diagnosis of intramedullary spinal cord lesions on MR imaging. AJR Am J Roentgenol. 170(6):1645-9, 1998
                                                                                                  30. Squires LA et al: Diffuse infiltrating astrocytoma of the cervicomedullary region: clinicopathologic entity. Pediatr Neurosurg. 27(3):153-9, 1997
                                                                                                  31. Minehan KJ et al: Spinal cord astrocytoma: pathological and treatment considerations. J Neurosurg. 83(4):590-5, 1995
                                                                                                  32. Nemoto Y et al: Intramedullary spinal cord tumors: significance of associated hemorrhage at MR imaging. Radiology. 182(3):793-6, 1992
                                                                                                  33. Li MH et al: MR imaging of spinal intramedullary tumors. Acta Radiol. 32(6):505-13, 1991
                                                                                                  34. Scotti G et al: Magnetic resonance diagnosis of intramedullary tumors of the spinal cord. Neuroradiology. 29(2):130-5, 1987