JOURNAL OF PEDIATRIC OPHTHALMOLOGY & STRABISMUS September 1, 2009
Clinical Pathologic Study of a Cohort of Patients With Retinoblastoma From a Developing Country
by Maria E. Orellana, MD; Bruno F. Fernandes, MD, PhD; Carolina Arean, MD; Imelda Pifano, MD; Abdullah Al-Kandari, MD; Miguel N. Burnier, Jr., MD, PhD, FRCSC
PURPOSE
To describe the histopathologic characteristics of all retinoblastoma biopsy specimens received at one institution.
METHODS
All retinoblastoma biopsy specimens received between January 2000 and December 2005 were evaluated and a total of 109 eyes from 101 patients were studied.
RESULTS
There were 9 (8.3%) well differentiated, 25 (23.0%) moderately differentiated, and 66 (60.5%) poorly differentiated retinoblastomas. The most common growth pattern was mixed, comprising 81 (74.4%) cases. Vitreous seeding, invasion of the anterior chamber, and invasion of the optic nerve beyond the lamina cribrosa, was present in 79 (72.5%), 24 (22.0%), and 44 (40.4%) eyes, respectively. The tumor was confined to the retina in only 26 (23.9%) cases, whereas 16 (14.8%) had minimal choroidal invasion, 45 (41.3%) had massive choroidal involvement, 10 (9.2%) had scleral invasion, and 11 (10.1%) had extraocular extension.
CONCLUSION
In this study, the percentage of patients with choroidal and optic nerve invasion, reflecting a poor prognosis, was much higher than in previously reported North American series. However, similar findings have been described in other developing countries, where late diagnosis is common. This study emphasized the need for early diagnosis and treatment.
[J Pediatr Ophthalmol Strabismus 2009;46:294-299.]
AUTHORS
From the Ocular Pathology Section (MEO, CA, IP), Instituto Anatomopatologico “Dr. J. A. O’Daly,” Universidad Central de Venezuela, Caracas, Venezuela; the Henry C. Witelson Ocular Pathology Laboratory (BFF, AA, MNB), Department of Ophthalmology, McGill University, Montreal, Québec, Canada; and the Department of Ophthalmology (MNB), Federal University of São Paulo, São Paulo, Brazil.
Originally submitted November 29, 2007. Accepted for publication February 27, 2008. Posted online March 20, 2009.
Presented in part at the Association for Research in Vision and Ophthalmology annual meeting, May 6-10, 2007, Fort Lauderdale, Florida.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Bruno F. Fernandes, MD, PhD, 3775 University Street, Room 216, Montreal, Quebec, Canada H3A-2B4.
doi: 10.3928/01913913-20090903-07
