Abstract
Purpose :
Childhood ocular tumors represent a clinical challenge and delayed diagnosis can result in serious consequences. Histopathology remains the gold standard for accurate diagnosis and proper treatment. Most childhood ocular tumors are benign, however malignant neoplasms such as retinoblastoma and rhabdomyosarcoma are important causes of vision loss and can be life-threatening. The aim of this study is to evaluate the clinical and histopathological features of childhood ocular tumors.
Methods :
Clinical and histopathological data on children who underwent ocular biopsies from 2006-2018 in the MUHC-McGill University Ocular Pathology & Translational Research Laboratory were evaluated. Biopsies were stained with H&E. Immunohistochemistry and special stains were applied in difficult and rare cases. Descriptive data on the site of ocular tumor involvement, frequency, histopathological type, diagnosis, sex and age were correlated.
Results :
A total of 6711 specimens were seen in the Laboratory. Of these, 115 cases (1.71%) were in patients aged 0-18 years. The average age was 13.6±5.0 years and eyelid lesions were the most prevalent (51.37%). Tumors were the least frequent (10.09%) in patients aged 0-4 years, however this age group represents the largest proportion of malignancies (71.4%), mainly retinoblastoma (45.45%).
Inflammatory, benign and malignant lesions corresponded to 52.3%, 41.3% and 6.4%, respectively. The majority of inflammatory lesions were in patients aged 15-18 years. Both malignant and benign lesions showed a predominance in boys compared to girls (57.14%vs.42.86% and 53.33%vs.46.67%, respectively).
The most common lesions were chalazion (31.19%), followed by nevus (24.77%), pyogenic granuloma (6.42%) and retinoblastoma (4.58%). Eyelids were the most common location of the ocular lesions in children.
Conclusions :
Inflammatory and benign tumors represent the vast majority of ocular lesions in children. Chalazion and benign melanocytic lesions are the most prevalent in this age group. Retinoblastoma is the most common malignant tumor in young children. Correlating the clinical characteristics, such as age of onset, peak prevalence and location with the histopathological characteristics is essential for a final diagnosis. Accurate interpretation of clinicopathological findings is the key for diagnosis and determining the most appropriate strategy to manage these ophthalmic lesions.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.