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Bin Li, Haixia Bai; The Histopathological Changes of Recurrent Retinoblastoma After Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1640.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze and summarize the histopathological changes of recurrent retinoblastoma after vitrectomy, to provide a necessary basis for its treatment.
We retrospectively analyzed the histopathological features of retinoblastoma eyeballs enucleated from 2014 to 2016 because of tumor recurrence after vitrectomy therapy.
The study included 18 globes of 18 patients (12 males) with a mean age of 4.4 ± 2.2 years (1.3-9.8 years) at enucleation.The tumor stage was D or E at diagnosis. After failure of conservative treatment, the 18 cases were performed vitrectomy, 6 cases of which had undergone two or more intraocular surgeries. Finally, all of the 18 eyes were enucleated because of tumor recurrence. The average interval between vitrectomy to tumor recurrence was 7 ± 5 months (2-17 months). In histopathological examination, 10 eyes (55.6%) showed a diffuse tumor infiltration in a plaque-like form without visible tumor mass, 2 eyes (11.1%) showed a diffuse tumor infiltration with massive tumor mass, other 6 eyes (33.3%) showed focal or scattered tumors. High histopathological risk factors(HRF) were found in 11 cases (61.1%), involving anterior segment invasion, massive choroidal invasion, postlaminar optic nerve invasion, scleral invasion and extraocular extension. All of the 11 eyes with HRF showed anterior segment invasion.
Relapsing retinoblastoma after vitrectomy often showed a diffuse tumor infiltration in a plaque-like form. There was a risk of tumor recurrence or metastasis in the eyes with HRFs, which should be given postoperative adjuvant therapy after enucleation. In view of the biological characteristics of retinoblastoma cells and the special anatomical structure of eye, therefore, retinoblastoma always prone to recurrence after vitrectomy, we must strictly grasp the indications of vitrectomy, give careful treatment and close follow up for the patients with retinoblastoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
General view of an enucleated eyeball with recurrent retinoblastoma after vitrectomy
Histopathological general view of an enucleated eyeball with recurrent retinoblastoma after vitrectomy
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