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尼日利亚卡诺市视网膜母细胞瘤的临床病理模式及治疗

Clinicopathological pattern and management of retinoblastoma in Kano, Nigeria.

作者信息

Abdu Lawan, Malami Sani

机构信息

Department of Ophthalmology, Faculty of Medicine, Bayero University Kano, Nigeria.

出版信息

Ann Afr Med. 2011 Jul-Sep;10(3):214-9. doi: 10.4103/1596-3519.84705.

Abstract

BACKGROUND

The aim of the study is to evaluate the pattern of presentation and the mode of management of retinoblastoma seen in Aminu Kano Teaching Hospital, Kano from 2001 to 2005.

MATERIALS AND METHODS

The clinic register was used to obtain the case folders of all children treated for retinoblastoma and this was used to obtain information on patient's age, sex, and clinical sign(s) at presentation such as orbital mass, leucocoria, proptosis, hyphaema without history of trauma, unexplained hypopyon, or uveitis. Also documented were X ray/B mode ultrasound scan findings, type of surgery performed, histological diagnosis, and adjuvant chemotherapy where applicable.

RESULTS

Forty-two patients were reviewed, 15 males and 27 females (M: F = 1.0: 1.8). The age ranged between 2 and 6 years and the peak age of presentation was 3 years in 22 patients (52%). The tumor was unilateral in 40 patients (95%) and bilateral in 2 patients (5%). Most of the patients (46%) presented late with fungating orbital mass. Other signs include leucocoria 22%, proptosis 19%, hyphema 7%, Hypopyon 2%, squint 2%, and buphthalmos 2%. Thirty-one patients (74%) had exenteration and enucleation was performed in 11 patients (26%). The tumor was histologically confirmed in 41 patients (98%) and was poorly differentiated in 23 patients (55%), 1 patient (2%) had toxocara granuloma. Thirty-nine patients required adjuvant chemotherapy and only 2 received 6 (full) courses.

CONCLUSION

Retinoblastoma, a treatable tumor is characterized by late presentation as illustrated in our study. There is need to create public awareness and educate mothers on this tumor so that there is early diagnosis, appropriate referral, and prompt treatment. The goal is to increase number of children successfully cured of this disease in our environment.

摘要

背景

本研究旨在评估2001年至2005年期间在卡诺的阿米努·卡诺教学医院所诊治的视网膜母细胞瘤的临床表现模式及治疗方式。

材料与方法

利用临床登记册获取所有接受视网膜母细胞瘤治疗儿童的病历夹,并据此获取患者的年龄、性别以及就诊时的临床体征信息,如眼眶肿物、白瞳症、眼球突出、无外伤史的前房积血、不明原因的前房积脓或葡萄膜炎。还记录了X线/B型超声扫描结果、所施行的手术类型、组织学诊断以及适用时的辅助化疗情况。

结果

共回顾了42例患者,其中男性15例,女性27例(男∶女 = 1.0∶1.8)。年龄范围在2至6岁之间,就诊的高峰年龄为3岁,有22例患者(52%)。肿瘤单侧发生40例(95%),双侧发生2例(5%)。大多数患者(46%)就诊时表现为眼眶肿物呈真菌样生长。其他体征包括白瞳症22%、眼球突出19%、前房积血7%、前房积脓2%、斜视2%以及牛眼2%。31例患者(74%)接受了眶内容剜除术,11例患者(26%)进行了眼球摘除术。41例患者(98%)的肿瘤得到组织学确诊,其中23例患者(55%)为低分化,1例患者(2%)有弓蛔虫性肉芽肿。39例患者需要辅助化疗,只有2例接受了6个(完整)疗程的化疗。

结论

视网膜母细胞瘤是一种可治疗的肿瘤,如我们的研究所表明的,其特点是就诊晚。有必要提高公众意识并对母亲们进行关于这种肿瘤的教育,以便能早期诊断、恰当转诊并及时治疗。目标是增加在我们所处环境中成功治愈这种疾病的儿童数量。

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