Authors: Marieta Dumitrache, Manea M, Miruna Cioboata, Rodica Lascu.
Retinoblastoma (RB) is the most common primary malignant intraocular tumor in children of 1-3 years old, with staged evolution, which has a favorable response if the diagnosis is made early. The major clinical signs are: leukocoria (white reflex in the pupil amaurotic cat’s eye), strabismus, painful, red eye, associated with orbital inflammation, exophthalmos, lymph node or brain metastases, intracranial hypertension. RB requires for diagnostic confirmation, CT scan, MRI highlighting calcifications, optic nerve invasion, CNS extension, presence of pineoblastoma, B-scan ultrasound.
RB can be complicated by: cataract, secondary glaucoma, retinal detachment, vitreous hemorrhage. The prognosis of the disease is relatively good, with 70-85% survival rate, if enucleation was done before the extraocular extension of the tumor.
Treatment in RB depends on the size and location of the tumor:
- stage 1 tumors, without invasion of the optic nerve, require cryotherapy, radiotherapy; the consumptive treatment of RB is controversial.
- RB is a radiosensitive tumor; external radiotherapy must be individualized according to the size and location of the tumor, bilateralization, metastasis, and can be external radiotherapy and brachytherapy in the form of radioactive plates placed on the site where the tumor is.
- enucleation is indicated in large tumors; extensive RD, in optic nerve invasion, secondary glaucoma In RB with intracranial orbital extension or distant metastases, palliative treatment is required: chemotherapy, exenteration, external radiotherapy. Chemotherapy with carboplatin, etoposide, vincristine, cyclosporine, is strengthened by laser photocoagulation, cryotherapy, brachytherapy.
In RB with intracranial orbital extension or distant metastases, palliative treatment is required: chemotherapy, exenteration, external radiotherapy. Chemotherapy with carboplatin, etoposide, vincristine, cyclosporine, is strengthened by laser photocoagulation, cryotherapy, brachytherapy.
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