Yang Jing, Dang Yalong, Zhu Yu, Zhang Chun
Department of Ophthalmology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou City, Henan Province, People's Republic of China ; Department of Ophthalmology, Peking University Third Hospital, Beijing, People's Republic of China ; Clinical Stem Cell Research Center, Peking University Third Hospital, Beijing, People's Republic of China.
Department of Ophthalmology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou City, Henan Province, People's Republic of China.
Onco Targets Ther. 2015 Jul 22;8:1815-21. doi: 10.2147/OTT.S79498. eCollection 2015.
Diffuse anterior retinoblastoma is a rare variant of retinoblastoma seeding in the area of the vitreous base and anterior chamber. Patients with diffuse anterior retinoblastoma are older than those with the classical types, with the mean age being 6.1 years. The original cells of diffuse anterior retinoblastoma are supposed to be cone precursor. Patients most commonly present with pseudouveitis, pseudohypopyon, and increased intraocular pressure. The retina under fundus examination is likely to be normal, and the clinical features mimic the inflammation progress, which can often lead to misdiagnosis. The published diffuse anterior retinoblastoma cases were diagnosed after fine-needle aspiration biopsy running the potential risk of inducing metastasis. The most common treatment for diffuse anterior retinoblastoma is enucleation followed by systematic chemotherapy according to the patient's presentation and clinical course. This review summarizes the recent advances in etiology (including tumorigenesis and cell origin), pathology, diagnosis, differential diagnosis, and new treatment. The challenges of early diagnosis and prospects are also discussed.
弥漫性前部视网膜母细胞瘤是视网膜母细胞瘤的一种罕见变体,肿瘤细胞播散于玻璃体基底部和前房区域。弥漫性前部视网膜母细胞瘤患者的年龄比经典类型患者大,平均年龄为6.1岁。弥漫性前部视网膜母细胞瘤的原始细胞被认为是视锥前体细胞。患者最常见的表现为假葡萄膜炎、假前房积脓和眼压升高。眼底检查时视网膜可能正常,其临床特征类似炎症进展,常导致误诊。已发表的弥漫性前部视网膜母细胞瘤病例是在细针穿刺活检后确诊的,存在诱发转移的潜在风险。弥漫性前部视网膜母细胞瘤最常见的治疗方法是眼球摘除术,然后根据患者的表现和临床病程进行系统化疗。本文综述了弥漫性前部视网膜母细胞瘤在病因学(包括肿瘤发生和细胞起源)、病理学、诊断、鉴别诊断及新治疗方法等方面的最新进展。同时也讨论了早期诊断面临的挑战和前景。