Clinicopathological pattern and management of retinoblastoma in Kano, Nigeria

Abstract

Background:The aim of the study is to evaluate the pattern of presentation and the mode of management of retinoblastoma seen in Aminu Kano Teaching Hospital, Kano from 2001 to 2005. Materials and Methods: The clinic register was used to obtain the case folders of all children treated for retinoblastoma and this was used to obtain information on patient's age, sex, and clinical sign(s) at presentation such as orbital mass, leucocoria, proptosis, hyphaema without history of trauma, unexplained hypopyon, or uveitis. Also documented were X ray/B mode ultrasound scan fi ndings, type of surgery performed, histological diagnosis, and adjuvant chemotherapy where applicable. Results: Forty-two patients were reviewed, 15 males and 27 females (M: F = 1.0: 1.8). The age ranged between 2 and 6 years and the peak age of presentation was 3 years in 22 patients (52%). The tumor was unilateral in 40 patients (95%) and bilateral in 2 patients (5%). Most of the patients (46%) presented late with fungating orbital mass. Other signs include leucocoria 22%, proptosis 19%, hyphema 7%, Hypopyon 2%, squint 2%, and buphthalmos 2%. Thirty-one patients (74%) had exenteration and enucleation was performed in 11 patients (26%). The tumor was histologically confi rmed in 41 patients (98%) and was poorly differentiated in 23 patients (55%), 1 patient (2%) had toxocara granuloma. Thirty-nine patients required adjuvant chemotherapy and only 2 received 6 (full) courses. Conclusion: Retinoblastoma, a treatable tumor is characterized by late presentation as illustrated in our study. There is need to create public awareness and educate mothers on this tumor so that there is early diagnosis, appropriate referral, and prompt treatment. The goal is to increase number of children successfully cured of this disease in our environment.

Managing Retinoblastoma at a Tertiary Eye Hospital in Kaduna, Nigeria - A Five Year Retrospective Cohort Review

“…More than half of our study subjects presented with leukocoria and intraocular stage of disease while 40% presented with orbital disease. This is similar to findings in Lagos [19] but contrary to reports from Kano (Nigeria) [9], Sudan [11], Zambia [12] where extraocular disease was the main presentation. Some of the reasons could be: (i) NECK receives referrals from all over Nigeria particularly the Northern states which have a large population (ii) Being a government -owned tertiary eye hospital our services are relatively cheap, and we provided waivers for consultation, accommodation, anaesthesia and surgery fees for this lifethreatening condition.…”

“…Managing RB (and other malignancies) in developing countries is challenging due to a complex interplay of multiple factors such as lack of awareness, poor access to health care, delayed diagnosis, inadequate treatment facilities, financial constraints, socio-cultural factors etc [5,6,8,9] These culminate in late presentation with advanced disease, resulting in survival rates of between 23% to 70% [10][11][12] compared to >90% in more advanced nations [13,14].…”

Association of retinoblastoma with clinical and histopathological risk factors

“…While similar procedures option was found in a study by Addu et al (2011). They performed thirtyone patients (74%) had exenteration and enucleation was performed in 11 patients (26%) [20].…”

Clinical characteristics and prognosis of patients with retinoblastoma: 8-year follow-up

“…Orbital invasion rarely occurs in Rb patients in developed and developing countries (11,18), but it is the most common symptom of Rb patients in less developed countries (22)(23)(24). Although patients with orbital invasion accounted for only 4.8% of all Rb patients in our study, their death rate accounted for 21.1% of Rb patients, with a survival rate of only 17.8%.…”