{"id":12700,"date":"2026-03-25T06:37:09","date_gmt":"2026-03-25T05:37:09","guid":{"rendered":"https:\/\/neurohirurgija.in.rs\/?page_id=12700"},"modified":"2026-06-18T05:33:04","modified_gmt":"2026-06-18T03:33:04","slug":"astrocytoma-brain-tumor","status":"publish","type":"page","link":"https:\/\/neurohirurgija.in.rs\/en\/astrocytoma-brain-tumor\/","title":{"rendered":"Astrocytoma \u2014 Types, Symptoms, Diagnosis, Treatment and Prognosis"},"content":{"rendered":"\n
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\n Author:<\/span>\n \n Dr. Zeljko Kojadinovic, MD, PhD\n <\/a>\n \u2014 Consultant Neurosurgeon\n <\/div>\n\n
\n Specialized Experience:<\/span>\n 30 years of clinical expertise in neurosurgery.\n <\/div>\n\n
\n Last medically reviewed:<\/span>\n February 28, 2026\n <\/div>\n<\/div>\n\n\n\n
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Who This Astrocytoma Page Is For<\/h3>\n <\/div>\n\n

\n This page is intended for patients diagnosed with astrocytoma, as well as for family members and caregivers who are seeking a clear, structured explanation of the disease, its biological behavior, and treatment options.\n <\/p>\n\n

\n Readers are not expected to read this page from start to finish. Instead, you may return to specific sections over time \u2014 when MRI findings change, seizures occur, treatment decisions arise, or new questions appear during follow-up.\n <\/p>\n\n

\n If treatment recommendations differ, it is unclear whether surgery, radiotherapy, or chemotherapy is needed, or if you want to better understand the long-term strategy and prognosis in your specific situation, an individualized\n \n neurosurgical second opinion\n <\/a>\n can help clarify options and define a realistic, long-term treatment plan.\n <\/p>\n<\/div>\n\n\n\n

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\n When patients and families seek a second opinion for astrocytoma\n <\/div>\n\n
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\u2022 It is uncertain whether surgery, biopsy, or observation is the safest next step<\/div>\n
\u2022 There is doubt about the need for radiotherapy or chemotherapy (Temozolomide)<\/div>\n
\u2022 Seizures are difficult to control, worsening, or it is unclear whether surgery could help<\/div>\n
\u2022 MRI follow-up suggests that the tumor may be growing again, coming back, or that changes may be treatment-related<\/div>\n
\u2022 The tumor may be growing again, and doctors are discussing another surgery, repeat biopsy, further treatment, or clinical trials<\/div>\n
\u2022 Different specialists provide different or conflicting recommendations<\/div>\n
\u2022 A clear long-term strategy, recurrence plan, and realistic prognosis are not well explained<\/div>\n <\/div>\n\n
\n In astrocytoma, decisions often depend on tumor grade, IDH status, MRI changes, seizure control, and whether the tumor may be growing again. An independent neurosurgical opinion can help clarify the safest next step.\n If this reflects your situation, you may request an individualized neurosurgical review here:\n \n Request Second Opinion\n <\/a>\n<\/div>\n\n<\/div>\n\n\n\n
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\n Astrocytoma \u2014 Quick Summary (Read This First)\n <\/h3>\n\n
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  • Astrocytoma is a diffuse infiltrative brain tumor (glioma).<\/strong> Tumor cells extend microscopically beyond what is visible on MRI, which means it cannot be completely separated from normal brain tissue.<\/li>\n\n
  • \n In adults, astrocytoma is defined by IDH mutation.<\/strong>\n To be classified as a diffuse astrocytoma of any grade (2\u20134), the tumor must carry an IDH mutation.\n IDH-wildtype diffuse tumors are generally classified as glioblastoma, even when they appear less aggressive on histology.\n <\/li>\n\n
  • \n In adults, it exists as a spectrum of grades (2\u20134), not separate diseases.<\/strong>\n Grade 2 tumors usually grow more slowly,\n grade 3 tumors show more active biological behavior,\n and grade 4 represents the most aggressive stage within the same disease continuum.\n <\/li>\n\n
  • \n Surgery is usually the first and most important treatment step, especially for Grade 2 tumors.<\/strong>\n Resection is not based on a clear boundary, but on removing all MRI-visible abnormal tissue (T2\/FLAIR), often including an entire anatomical region when safe.\n In higher grades (3\u20134), surgery is still essential but is typically followed by additional oncologic treatment.\n <\/li>\n\n
  • \n MRI with contrast is the key diagnostic and follow-up tool.<\/strong>\n Grade 2 tumors often show little or no contrast enhancement,\n while grade 3 and especially grade 4 tumors more commonly enhance and may show necrosis and edema.\n However, MRI always underestimates the full microscopic extent of disease.\n <\/li>\n\n
  • \n Additional treatment depends strongly on tumor grade.<\/strong>\n Some patients with low-risk grade 2 astrocytoma may be observed after surgery.\n In grade 3 and grade 4 tumors, postoperative treatment is usually required and includes radiotherapy and Temozolomide.\n <\/li>\n\n
  • \n Radiotherapy and chemotherapy follow specific protocols.<\/strong>\n Grade 2 tumors are typically treated with approximately 50\u201354 Gy when indicated,\n while grade 3 and grade 4 tumors usually receive higher doses (~59\u201360 Gy) combined with Temozolomide (concurrent and adjuvant).\n <\/li>\n\n
  • \n The disease course varies widely depending on grade.<\/strong>\n Grade 2 astrocytomas often have a long course (commonly around 8\u201315+ years), \n grade 3 astrocytomas typically remain a long-survival disease compared with glioblastoma (often around 5\u201310 years), \n while grade 4 IDH-mutant astrocytoma is a serious malignant disease, although survival often extends to several years (commonly around 2\u20134 years).\n<\/li>\n\n
  • \n Seizures are common, especially in lower grades.<\/strong>\n They may be the first symptom and often improve after surgery, but may require long-term management.\n If epilepsy is the only indication for surgery in a stable MRI lesion suspected to be an astrocytoma, it is essential to confirm that the lesion is truly the source of seizures before proceeding.\n<\/li>\n\n
  • \n Long-term follow-up is essential.<\/strong>\n Even after treatment, astrocytoma can recur or progress over time, and regular MRI monitoring is required.\n <\/li>\n\n
  • This page is structured so you can read only what matters to you.<\/strong> Use the Contents box to navigate to sections on diagnosis, surgery, treatment, recurrence, and prognosis.<\/li>\n\n <\/ul>\n<\/div>\n\n

    \n Most readers benefit from the Quick Summary plus the sections on Treatment<\/strong>, When Surgery Is Not Recommended<\/strong>, and Prognosis<\/strong>. The remaining sections provide deeper understanding.\n<\/p>\n\n\n\n