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High-Grade Astrocytoma

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Posted by fatima.shakeel@opmc.co | Mar 12, 2026

What is a High-Grade Astrocytoma?

High-Grade Astrocytoma with Piloid Features, also called HGAP, is a rare type of brain tumour. It was recently recognised as a separate tumour in the updated classification of brain tumours by the World Health Organization.

Under the microscope, some parts of this tumour look like a less dangerous tumour called Pilocytic Astrocytoma, but HGAP behaves more aggressively. “High-grade” means it grows faster and can spread into nearby brain tissue. It is seen mostly in children and young adults, but it can occur at any age.

Incidence

HGAP is very rare. Because it has only recently been defined as a separate tumour type, exact numbers are not clearly known yet. It forms only a small portion of all brain tumours.

Symptoms

Symptoms depend on where the tumour is located in the brain. Common symptoms include long-lasting headaches, vomiting (especially in the morning), seizures, weakness in arms or legs, vision problems, difficulty walking or balancing, and sometimes changes in behaviour or personality. Symptoms usually become worse as the tumour grows.

Diagnosis

Diagnosis usually starts with an MRI scan of the brain, which helps detect the tumour clearly. A CT scan may also be done. To confirm the diagnosis, surgery is performed to remove part or all of the tumour. The removed tissue is examined under a microscope. Special genetic tests are also done because this tumour has certain molecular changes that help doctors identify it correctly.

Treatment

Treatment usually includes surgery to remove as much of the tumour as possible. After surgery, radiotherapy and chemotherapy are often given because it is a high-grade tumour. Treatment is usually planned by a team of brain specialists.

Prognosis

The outcome is not as good as low-grade brain tumours. Survival depends on the patient’s age, tumour location, how much tumour was removed, and its genetic features. Early diagnosis and complete removal improve the chances of better survival.


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