Introduction:Histopathological features in retinoblastoma are considered high-risk factors (HRF) for tumor progression and metastasis, thus their presence becomes an indication for adjuvant chemotherapy. Present study was undertaken to evaluate the incidence of HRF in retinoblastoma and to correlate them with p53 expression.Materials and Methods:This was a retrospective study where 17 diagnosed cases of retinoblastoma were included. Cases were re-evaluated for various histomorphological parameters. Immuno-histochemical analysis was done with p53 antibody by Streptavidin biotin method.Results:The patients were in the age range of 1.5-50 years. Common histological features included necrosis (70.5%), calcification (64.7%), and retinal detachment (58.8%). Incidence of various morphological parameters was anterior chamber seeding (47.2%), ciliary body involvement (29.4%), iris involvement (29.4%), choroid involvement (58.8%), scleral invasion (29.4%), extrascleral invasion (11.8%), and optic nerve infiltration (23.5%). p53 expression was present in four cases out of 13 cases (30.7%) and showed a significant association with choroid invasion (P = 0.02).Discussion:The presence of HRF should alert the physician for a possible metastasis, and such patients should be kept on regular follow-up to detect an early recurrence. p53 expression, a known poor prognostic indicator, showed significant association with choroid invasion, however, no association was seen with other HRF.Conclusion:Histopathological HRF have significant therapeutic and prognostic implications. The incidence of HRF is higher in developing countries as patients present with a more advanced stage of disease. p53 expression is significantly associated with choroid invasion out of all HRF.

A 38-year-old lady presented with a left shoulder swelling. The swelling had been present for the last 5 years and showed gradual enlargement since the last 1 year. On examination a firm swelling was noted in the left shoulder measuring 2x1.5x1cm. The swelling was not fixed to overlying skin. She had no other significant history. No significant haematological findings or systemic disease. With a clinical suspision of calcified parasitic cyst the patient was operated upon.We received a single globular grey white mass that measured 1x0.5x0.5cm. It was firm to hard in consistency. On cut section it was gritty. On microscopic examination a well circumscribed lesion was present with extensive areas of calcification and ossification. DISCUSSIoNPilomatricoma, also known as "calcifying epithelioma of Malherbe" is a tumour which shows differentiation towards hair cells, particularly hair cortex cells [1]. Four clinical variants have been described. They are: 1) eruptive type; 2) perforating type; 3) familial type (associated with myotonic dystrophy); and 4) recurrent invasive, non-metastatic pilomatrix carcinoma [2].In a study by M. Valluvan et al., on skin adnexal tumours over a span of 10 years only a single case of pilomatricoma with myeloid metaplasia was reported [2]. Also, in another study by Steven Kaddu et al., seven cases of pilomatricomas with EMH were found in a span of 16 years. Two out of these seven showed myeloid erythroid and megakaryocytes while rest were with myeloid and or erythroid precursor cells [3]. They found that this phenomenon is not uncommon in pilomatricoma with an overall incidence of 5.8%. Ackerman et al. in 1993 studied 120 cases of pilomatricomas and had noted EMH in seven cases [4]. Only two lesions showed osseous metaplasia. The variable incidence of this entity can thus be ascertained from the incidences quoted by different authors.Cutaneous EMH has rarely been docu mented. ABStRACtPilomatricoma is a benign follicular skin appendage tumour. It usually occurs as solitary lesion and is most commonly seen in the face and upper extremeties. Here we report a rare case of extramedullary haematopoiesis (EMH) in pilomatricoma in a 38-year-old lady.

No abstract