EVALUATION OF HISTOPATHOLOGICAL RISK FACTORS IN ENUCLEATED RETINOBLASTOMA EYES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 1
Abstract
BACKGROUND Recent advance in radiotherapy and chemotherapy has revolutionised the treatment and survival of retinoblastoma (RB) patients. Despite this success, presence of clinical, genetic and histopathological risk factors can lead to systemic metastasis of the disease. Documented histopathological (HP) risk factors for metastasis in retinoblastoma include choroidal invasion, trans-scleral migration and intra-neural invasion. The need for preventive chemotherapy in a patient is decided on evaluating these HP features in an enucleated eye. The aim of this study is to look for presence of HP risk factors in enucleated retinoblastoma eyes. MATERIALS AND METHODS This descriptive study was done at St. John’s Medical College Hospital (SJMCH) and Kidwai Institute of Oncology (KMIO), Bangalore from May 2005 to January 2015. It is partly retrospective and largely prospective study. Thirty nine eyes of 39 Retinoblastoma patients were included in the study. Their age and sex were noted. Ocular examination findings were documented. Detailed histopathological examination of enucleated eyes and the slides were done to look for presence of HP risk factors like choroidal invasion, scleral extension and optic nerve involvement, etc. Patients having histopathological risk factors were started on adjuvant chemotherapy. RESULTS Thirty nine enucleated eyes of 39 patients were included in the study during the study period. The mean age of these 39 patients was 3 years. Tumour was unilateral in 21 (53.8%) cases and bilateral in 18 (46.2%) cases. Sixteen eyes had Grade-IV and 23 eyes had Grade-V tumour by Reese-Ellsworth staging. On histopathological examination, nine eyes out of 39 (23%) showed presence of HP risk factors like choroidal invasion – 6 cases (15.3%), scleral infiltration – 2 cases (5%), post laminar optic nerve invasion – 6 cases (15.3%) and optic nerve sheath invasion – 3 cases (7.6%). Four children (10.2%) had systemic metastasis in the series. CONCLUSION Presence of histopathological risk factors in enucleated retinoblastoma eyes have significant therapeutic and prognostic value. All enucleated eyes should be carefully checked for presence of any of these factors and if these features are there, then subsequent antimetastatic treatment should be started for the patients.
Authors and Affiliations
Nibedita Acharya, Usha Vasu
Keywords
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- EP ID EP283332
- DOI 10.14260/jemds/2018/3
- Views 74
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