chapter  11
Astroblastoma
ByMarc K. Rosenblum
Pages 10

It is as well that we follow previous commentators in acknowledging at the outset of this discussion the doubts that have surrounded the identity of the so-called astroblastoma since its forwarding as a distinct tumor type by Percival Bailey and Harvey Cushing (1926). This they conceived as a neoplasm composed predominantly of cells having the features of embryonic glial elements – ‘astroblasts’ – destined, in formulations of central neurocytogenesis then current, to become the mature astrocytes of the developed brain and characterized by an attachment to regional blood vessels via unipolar cytoplasmic processes terminating in expanded footplates. In a subsequent analysis of 25 putative cases (these culled mainly from the tumor collection maintained by Dr Cushing), Bailey and Bucy (1930) alluded to the contested nature of the astroblastoma and recognized that the basis for skepticism in the acceptance of this entity lay in the fact that neoplasms qualifying for this designation evidenced, by the authors’ own admission, ‘insensible transitions to the glioblastoma multiforme, the ependymoblastoma [sic] and the astrocytoma’. As a group, the lesions collected in this series exhibited a predilection for the cerebral hemispheres of adults (the mean age at diagnosis was 38 years; 14 patients were beyond 40 years of age and only one child was affected), a tendency to infiltrative growth, a high case fatality rate, and a temporal evolution from symptom onset to death (37 months, on average) falling between the approximate survival periods associated at that time with the astrocytoma (75 months) and glioblastoma (12 months). Given such attributes and the rather

heterogeneous morphologic picture that emerges from the provided illustrations, it is difficult to resist concluding that many of these growths would be regarded by today’s practitioners as essentially representing variants of anaplastic astrocytoma.