Rhegmatogenous Retinal Detachment and Retinoblastoma

Abstract

Abstract: : Only the exudative form of retinal detachment is thought to be associated with retinoblastoma. Purpose:To provide clinicopathological correlation demonstrating that rhegmatogenous retinal detachment can be the presenting sign of retinoblastoma. Methods: Fresh frozen and formalin fixed sections were prepared from the globe enucleated from a 7 year–old girl for persistent retinal detachment and intractable rubeotic glaucoma. The patient had undergone prior scleral buckling surgery. Preoperative studies showed photographically documented retinal break and detachment and a CT scan without any evidence of calcium. The pathological specimen was oriented to correlate with the location of the retinal break and detachment. Results: Histologic evaluation of the globe showed a total circumferential neurosensory retinal detachment with retinal breaks. Subretinal fluid greatly exceeded the tumor mass. The tumor had a largely exophytic growth pattern. In the superior quadrant, a focal area of retinal necrosis coincided with the major clinical break. This region showed full–thickness infiltration by tumor cells disrupting the normal retinal architecture and continuity. The tumor displayed typical cytological features of a poorly differentiated retinoblastoma.Conclusions: Retinoblastoma can masquerade as rhegmatogenous retinal detachment. We propose that tumor infiltration can be responsible for this phenomenon.

Keywords: retinal detachment • pathology: human • tumors