High-risk histomorphological features in retinoblastoma and their association with p53 expression: An Indian experience

Abstract

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.

Clinicopathological Findings of Retinoblastoma: A 10-Year Experience from a Tertiary Hospital in Kampala, Uganda

“…In the series of Darwich and associates [32], it was reported that patients with choroidal invasion were more likely to develop systemic metastasis compared to the ones with or without optic nerve invasion ( P =0.0001). Choroidal invasion has also been found to correlate with molecular prognostic markers such as TP53 unlike other high risk factors (HRF) as it was once reported by Seema and associates [33] in India.…”

Epidemiology and clinical features of retinoblastoma

“…This is slightly higher than some case series that quote an incidence of high-risk features in RB to be 40%-50%. [10] In 15% of the children, more than one risk feature were observed. These high-risk features are a concern mainly because they are associated with high incidence of extraocular relapse and low chances of recovering vision.…”

“…Chemotherapy if administered alone has inadequate central nervous system penetration and therefore can result in extraocular relapse. [10] We would like to emphasize that children with a white reflex must be screened at the earliest for underlying RB. Considering that it is the most common symptom and is likely to be picked up even in a photograph, it is important to sensitize the general pediatricians to routinely screen the children during vaccination visits.…”

Molecular pathologic interpretation of new retinoblastoma rosettes

“…Various IHC studies in RB pathology have shown prognostic clues for understanding the biology of this childhood cancer. [ 1 2 3 4 5 6 7 8 ] We took up the study to know the characteristics of newly described rosettes with various known immunomarkers for RB. The new rosettes were associated with histopathological high-risk factors and morphologically different from FW and HW rosettes.…”