Retinoblastoma (RB) is the most common malignant tumor of the retina in human children. Although it has been hypothesized for a long time that RB derives from multipotent retinal stem cells (RSCs) or retinoblasts, the direct evidence that the presence of tumorigenic RSCs in RB tumors is still lacking. Some studies indicate that malignant tumors contain tumor stem cells similar to their normal tissue stem cell counterparts. With in vitro culture and differentiation method we demonstrate that tumorigenic retinal stem-like cells (RSLCs) indeed exist in RB lesions and that RB tumor-derived cultures encompass undifferentiated cells capable of extensive proliferation as clonal nonadherent neurospheres and can differentiate into different retinal cells in vitro. Interestingly, cultured cells expressed retinal development related genes including nestin, CD133, pax6, chx10 and Rx, and overexpressed Bmi-1, a gene required for self-renewal and proliferation of stem cells. Significantly, when these cultured cells were intraocularly transplanted into SCID mice, they gave rise to new tumors with histomorphological features and immunophenotypes similar to their parental primary RBs. The results show that RBs contain tumorigenic RSLCs that contribute to tumorigenesis. This study provides a new insight to investigate the histogenesis of RBs and establishes a model for other RB research. ' 2007 Wiley-Liss, Inc.Key words: retinoblastoma; tumor stem cell; retinal stem cell; tumorigenesis Retinoblastom (RB) is the most common malignant tumor of the retina in children and has become an excellent study model for cancer biology and molecular mechanism. [1][2][3][4][5][6] It is categorized into differentiated and undifferentiated types by the World Health Organization (WHO) classification according to the presence of rosettes and the degree of atypia. 2 Most of previous studies have been focusing on the cellular and molecular analysis of the bulk tumor mass to search cell origin of RB tumor and RB gene mutation. Although the origin of RB cells has been somewhat controversial, it has been generally agreed that RB cells originate from the multipotent primitive retinoblasts or retinal stem cells (RSCs). 3,[7][8][9][10][11][12][13][14][15][16] Up to date, there is no direct evidence to support that tumorigenic RSCs exist in RBs. In recent years, brain tumor stem cells (BTSCs) have been isolated from human brain malignant tumor samples and cultured then transplanted into experimental animals to form new tumors, providing strong evidence that these BTSCs are the origin of the brain tumor. [17][18][19] In 2005, Siegal et al. demonstrated that mouse and human RB cells contained a small subpopulation of cells exhibiting a cancer stem cell-like phenotype. 20 Recently, our research group successfully cultured stemlike cells from human RB lesions using the methods culturing BTSCs and RSCs. 19,21 Our previous data showed that these stemlike cells exhibited RSC properties in vitro including extensive proliferation, self-renewal and multipotency. 22 H...