Workup for Metastatic Retinoblastoma

Karcioglu, Zeynel A.; Al-Mesfer, Saleh; Abboud, Emad B.; Jabak, Monzer; Mullaney, Paul

doi:10.1016/s0161-6420(97)30319-4

Cited by 59 publications

(35 citation statements)

References 18 publications

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“…27 The rate of bone marrow metastasis is relatively high in our study, but this may be due to the small numbers in our study therefore we cannot make any meaningful comparison with this lager series from Saudi Arabia. Similarly, the percentage of our patients who had CSF analysis, or CT imaging is too small to allow any meaningful comparison.…”

Section: Discussionmentioning

confidence: 65%

“…[26][27][28][29][30][31][32] Seventy-five percent of enucleated eyes in our series had one or more HHRF for metastasis. Optic nerve invasion was the commonest site of extraocular invasion in our series and correlates with that in other studies.…”

Section: Discussionmentioning

confidence: 99%

“…10 Our study has added to the importance of subjecting all enucleated eyes for histopathological analysis in order to identify those with HHRFs, the presence of which have adverse predictive value on prognosis. [26][27][28][29][30][31] Progressively small numbers of patients continued with follow up thus for 12 and 18 months durations there were only 1 without metastasis and 1 with metastasis respectively. This was also reflected in more than a third of the patients either abandoning treatment, 34.8%, or discharged with advanced disease and financial difficulty (8.7%), the latter group for palliative care at peripheral hospitals near their homes.…”

Section: Discussionmentioning

confidence: 99%

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Presentation of retinoblastoma at a paediatric eye clinic in Ghana

Essuman

Ct²,

Akafo³

et al. 2011

Ghana Medical Journal

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SUMMARYBackground: Retinobalstoma, the commonest childhood malignant intraocular tumour, is usually diagnosed early with over 90% survival rate in developed countries. In developing countries, the diagnosis is late resulting in less than 50% survival. Objective: To determine retinoblastoma stages at presentation and patients' outcomes. Design: Retrospective case series. Methods:The clinical and histopathological records of children with retinoblastoma seen from May 2004 to December 2005 were studied. Data was analysed for mode of presentation, laterality, clinical staging using Reese-Ellsworth (R-E) classification, histopathological high risk features (HHRF) for metastasis, and patient outcome. Setting: Ophthalmology Unit, Korle-Bu Teaching Hospital, Ghana. Results: Twenty-three patients presented with retinoblastoma over the period. Males were 12(52.2%). The age range from 1 to 84 months, mean 36.3(22.15) and median (36 months). Nineteen (82.6%) had unilateral and 4(17.4%) bilateral disease. The common clinical presentations were leukocoria in 20(87.0%), proptosis 8(34.8%), strabismus 5(21.7%) and red eye 5(21.7%). The clinical features were commensurate with R-E stage V in 20(87.0%) patients, 2(8.7%) with orbital recurrence and 1(4.3%) with post-enucleation anophthalmos. HHRFs were present in 9(75%) enucleated eyes with invasion of optic nerve as the commonest site (7/9). The patients were followed up for 1 day to 19 months. Eight abandoned treatment, 2 were discharged for palliative treatment, 2 out of 5 with metastasis died and 6 had no metastases at their last visit. Common sites for metastasis were the bone marrow, brain and orbit. Conclusion: Majority of the patients presented with advanced disease manifesting as leukocoria, proptosis, RE stages V disease and poor outcome.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Presentation of retinoblastoma at a paediatric eye clinic in Ghana

Essuman

Ct²,

Akafo³

et al. 2011

Ghana Medical Journal

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“…A high proportion of advanced disease at presentation was seen in previous studies from India [3,27] as well as the rest of the developing world [28,29]. However, these figures are in contrast to the Western world [26,30,31], where the incidence of extraocular disease has been reported to be less than 5%.…”

Section: Discussionmentioning

confidence: 88%

Retinoblastoma: A Sixteen-Year Review of the Presentation, Treatment, and Outcome from a Tertiary Care Institute in Northern India

Singh¹,

Katoch²,

Kaur³

et al. 2017

Ocul Oncol Pathol

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Purpose: To study epidemiology, demographic profile, clinical characteristics, and outcome in pediatric patients with retinoblastoma. Methods: This was a retrospective review of retinoblastoma patients of a tertiary institute from January 1st 1998 to December 31st 2014. Results: The study included 467 patients (618 eyes) with a mean age of 34.7 ± 24.6 months (median = 30; 15 days to 144 months). Retinoblastoma was bilateral in 151 (32.3%) and there were 61.7% males. Intraocular disease was seen in 301 patients (451 eyes [72.9%]) and extraocular in 166 patients (167 eyes; 27.0%). Out of the 347 (74.3%) who received treatment, primary treatment was chemoreduction in 228 (65.7%) and enucleation in 117 (33.7%), while 25.6% of patients refused treatment and 151 (43.5%) defaulted therapy. Local recurrence was seen in 20 (4.3%), metastasis in 2 (0.4%), and deaths in 13 (2.8%) (average follow-up 28.5 ± 44.4 months). Histopathological high risk features were significantly less in the eyes that received chemoreduction (5.0%) versus primary enucleation (20.8%) (p < 0.0004), but there was no difference in the rate of metastasis, recurrence, and death between the two. Conclusions: The majority of retinoblastoma patients in our study had advanced disease, and nearly a third had extraocular extension. There were a significant number of therapy refusals and dropouts. Chemoreduction led to a significant decrease in the histopathological risk factors without affecting the outcomes.

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“…Invasion of the optic nerve in retinoblastoma is one of the most important risk factors for metastasis (Magramm et al 1989;Karcioglu et al 1997;Finger et al 2002;Chantada et al 2004). Shields et al (1994) found post-laminar invasion of the optic nerve to be associated with increased mortality, whereas pre-laminar ⁄ laminar invasion had no impact on mortality.…”

Section: Clinical Implications Of Secondary Optic Nerve Tumoursmentioning

confidence: 99%

Primary and secondary tumours of the optic nerve, with emphasis on invasion by uveal malignant melanoma

Lindegaard

2007

Acta Ophthalmologica Scandinavica

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Tumours of the optic nerve may originate in the optic nerve itself (i.e. primary tumours) or in structures adjacent to the optic nerve (i.e. secondary tumours). Furthermore, leukaemic infiltration and tumour metastases from distant solid tumours are also found in the optic nerve (i.e. secondary tumours). Large surveys have described primary optic nerve tumours and their treatment modalities, whereas secondary tumours have received little attention. Most reported work-ups have been based on material from referral centres and specialized departments.The correlation between invasion of the optic nerve in uveal melanoma and the risk of death from the disease has not been fully elucidated. The impact on prognosis may be correlated with tumour cells left in the proximal nerve after enucleation. In addition, melanoma with secondary invasion of the optic nerve may represent a highly malignant invasive subcategory of uveal melanoma. Clinical factors that make the ophthalmologist aware of optic nerve invasion when investigating a uveal melanoma are most important.Melanomas that invade the optic nerve may histopathologically display different invasive patterns and represent different types of uveal melanoma. A subtype of uveal melanoma with a preponderance for neural invasion may exist. Such a subtype has been identified for cutaneous melanoma (desmoplastic ⁄ neurotropic).In order to investigate tumours of the optic nerve in a known population, we studied all optic nerve tumours that had been surgically removed in Denmark over a period of 25 years. Furthermore, in order to resolve questions about secondary invasion of the optic nerve in uveal melanoma, we investigated all eyes with uveal melanoma and optic nerve invasion enucleated in Denmark between 1942 and 2001 (n ¼ 157).Tumours of the optic nerve in children were dominated by optic glioma and invasion from retinoblastoma, whereas tumours in adults mainly comprised optic nerve sheath meningioma and invasion from uveal melanoma.Optic nerve invasion of uveal melanoma was found in one in 20 patients. Increased IOP and juxtapapillary location were associated with both pre-laminar ⁄ laminar and post-laminar invasion of the optic nerve. Furthermore, ageReuse of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation. Acta Ophthalmologica Scandinavica 20071 over 70 years, vision reduced to light perception, non-visible fundus and large tumour size were associated with post-laminar invasion. Only patients with optic nerve invasion had metastases to the CNS, kidney and heart. Histopathological features associated with optic nerve invasion were focal retinal invasion, neovascularization of the chamber angle and scleral invasion. Furthermore, non-spindle cell type and rupture of the ILM were all associated with post-laminar invasion.The optic nerve was invaded in four different ways:(1) by tumour extension from the neuroretina through the lamina cribrosa; (2) by direct extension into the optic ...

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Workup for Metastatic Retinoblastoma

Cited by 59 publications

References 18 publications

Presentation of retinoblastoma at a paediatric eye clinic in Ghana

Presentation of retinoblastoma at a paediatric eye clinic in Ghana

Retinoblastoma: A Sixteen-Year Review of the Presentation, Treatment, and Outcome from a Tertiary Care Institute in Northern India

Primary and secondary tumours of the optic nerve, with emphasis on invasion by uveal malignant melanoma

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