Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India.
Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Hyderabad, India.
Eur J Ophthalmol. 2021 Jul;31(4):2042-2047. doi: 10.1177/1120672120946285. Epub 2020 Jul 24.
To discuss the clinical presentation, management, and outcome of delayed metastasis in retinoblastoma (RB).
Retrospective case series of three patients.
Mean age at diagnosis of RB was 29 months (median, 28 months; range, 11-48 months). All were males with non-familial bilateral intraocular RB. Primary treatment for RB included intravenous chemotherapy in all three cases. Secondary treatment included transpupillary thermotherapy/cryotherapy ( = 6 eyes), periocular chemotherapy ( = 2 eyes), intravitreal chemotherapy ( = 1 eye), intra-arterial chemotherapy ( = 1 eye), external beam radiotherapy (EBRT; = 2 eyes), and enucleation ( = 2 eyes). Primary tumor regression was achieved in all cases and remained status quo at the time of diagnosis of distant metastasis. Two patients developed bone metastasis (ulna; tibia) and one developed soft tissue metastasis (temporal fossa) over a mean follow-up period of 6 years (median, 7 years; range, 5-8 years) from diagnosis of RB. Mean age of detection of metastatic disease was 8 years (median, 8 years; range, 7-9 years). All the lesions were solitary and the diagnosis of metastatic retinoblastoma was confirmed by tissue biopsy. Metastatic disease was treated with surgical excision ( = 1), chemotherapy ( = 2), and EBRT ( = 2). All patients are alive, with two patients free of disease over a mean follow-up period of 23 months (median, 23 months; range, 12-33 months); and 1 in remission 7 months after completion of EBRT.
Long-term follow-up of RB cases is mandatory. In spite of intraocular tumor regression, metastasis can still occur many years after treatment of RB.
讨论视网膜母细胞瘤（RB）延迟转移的临床表现、治疗和预后。
回顾性病例系列研究，共纳入 3 例患者。
RB 的诊断平均年龄为 29 个月（中位数，28 个月；范围，11-48 个月）。所有患者均为男性，双侧眼内非家族性 RB。所有患者均接受静脉化疗作为 RB 的初始治疗。后续治疗包括经瞳孔温热疗法/冷冻疗法（=6 只眼）、眶周化疗（=2 只眼）、玻璃体内化疗（=1 只眼）、动脉内化疗（=1 只眼）、外照射放疗（EBRT；=2 只眼）和眼球摘除术（=2 只眼）。所有患者的原发肿瘤均消退，在诊断远处转移时肿瘤仍保持稳定。2 例患者发生骨转移（尺骨；胫骨），1 例发生软组织转移（颞窝），从 RB 诊断到远处转移的平均随访时间为 6 年（中位数，7 年；范围，5-8 年）。转移性疾病的平均发现年龄为 8 岁（中位数，8 岁；范围，7-9 岁）。所有病变均为单发，经组织活检确诊为转移性 RB。转移性疾病采用手术切除（=1）、化疗（=2）和 EBRT（=2）治疗。所有患者均存活，2 例患者在平均 23 个月（中位数，23 个月；范围，12-33 个月）的随访中无疾病，1 例患者在 EBRT 完成后 7 个月缓解。
RB 病例必须进行长期随访。尽管眼内肿瘤消退，但 RB 治疗多年后仍可能发生转移。
