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Anaplastic Astrocytoma (Grade 3)

High-grade infiltrative astrocytoma — less aggressive than GBM but still malignant.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Anaplastic Astrocytoma (Grade 3)?

Anaplastic astrocytoma is a WHO grade 3 infiltrative glioma derived from astrocytic glial cells, accounting for roughly 4% of primary brain tumors. Median age at diagnosis is 40-50 years, younger than glioblastoma. Cellularity, nuclear atypia, and mitotic figures are present, but unlike GBM there is no microvascular proliferation or necrosis.

The 2021 WHO classification subdivides the entity into IDH-mutant (better prognosis, longer survival) and IDH-wildtype (which often behaves like GBM and is now classified as glioblastoma when molecular criteria are met). 1p/19q codeletion is absent — its presence reclassifies the tumor as oligodendroglioma. ATRX loss is common in IDH-mutant astrocytomas.

Treatment relies on maximal safe resection followed by adjuvant therapy. The standard regimen is radiotherapy plus PCV (procarbazine, lomustine, vincristine) or temozolomide. Median overall survival is 5-10 years for IDH-mutant disease, but only 1-2 years for IDH-wildtype tumors. Tumors recur and may transform into grade 4 over time.

Symptoms

Headache, often progressive
Seizures (frequently the first symptom)
Focal deficit depending on location (motor, language, visual)
Personality and cognitive changes
Nausea, vomiting (raised intracranial pressure)
Visual field defects
Gait disturbance
Limb weakness or numbness

Risk Factors

Middle age (40-50 years peak)
Prior cranial radiotherapy
Genetic syndromes (Li-Fraumeni, Turcot, NF1)
Prior low-grade glioma (transformation)
Male sex (slight predominance)
No proven environmental triggers
IDH-wildtype molecular signature predicts worse outcome
ATRX loss observed in IDH-mutant subset

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • First-ever adult-onset seizure
  • Progressive headache with vomiting
  • New focal neurological deficit
  • Personality and behavior changes
  • Visual field loss or diplopia
  • MRI mass requiring neuro-oncology referral

Treatment Methods

01
Surgery: maximal safe resection (awake mapping, intraoperative MRI when indicated)
02
Radiotherapy: 54-60 Gy focal field
03
Chemotherapy: PCV regimen or temozolomide (depending on molecular profile and tolerance)
04
Molecular profiling: IDH, 1p/19q, ATRX, MGMT testing
05
Recurrence: re-resection, re-irradiation, bevacizumab, clinical trials
06
Supportive: antiepileptics, corticosteroids for peritumoral edema
07
Long-term MRI surveillance to detect recurrence and high-grade transformation
08
Multidisciplinary neuro-oncology board for individualized planning

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.