Riazi-Esfahani Hamid, Masoomian Babak, Ghassemi Fariba
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ocular Oncology Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Case Rep Ophthalmol Med. 2021 Jul 9;2021:6639900. doi: 10.1155/2021/6639900. eCollection 2021.
Adult retinoblastoma (RB) is a rare intraocular tumor, leading to delayed diagnosis and, eventually, enucleation of the involved eyes. Therefore, this diagnosis should be considered if attributable signs and symptoms occurred. Here, the authors report a case of an adult group D RB, treated successfully with intra-arterial chemotherapy (IAC) as primary treatment followed by cryotherapy. The authors briefly review the literature on the prognosis and management of adult RB. . A 22-year-old man has noticed floaters in his right eye for 2 months. Right eye examination revealed diffuse white spherical calcified vitreous seeds in all quadrants and a large white endophytic mass in the superonasal quadrant with engorged feeding vessels. Based on clinical data, the group D RB tumor was classified and the IAC was started with 2 medications, melphalan (5 mg) and topotecan (1 mg), for 3 cycles. Trans-scleral triple freeze-thaw cryotherapy was used as an adjunctive treatment at the latest hospital visit. Thirteen months after the last treatment, the RB tumor showed type 4 regression (flat chorioretinal scar) and no evidence of recurrence was identified.
It seems that IAC, as the first line of treatment, either alone or in conjunction with adjuvant therapies may allow us to salvage the globe of adult patients involved with RB.
成人视网膜母细胞瘤（RB）是一种罕见的眼内肿瘤，常导致诊断延迟，最终患眼被摘除。因此，出现相关体征和症状时应考虑这一诊断。在此，作者报告一例成人D组RB病例，该病例以动脉内化疗（IAC）作为主要治疗方法，随后进行冷冻疗法，治疗成功。作者简要回顾了关于成人RB预后和治疗的文献。一名22岁男性右眼出现飞蚊症2个月。右眼检查发现所有象限均有弥漫性白色球形钙化玻璃体种子，鼻上象限有一个大的白色内生性肿块，供血血管迂曲。根据临床资料，对D组RB肿瘤进行分类，并开始使用美法仑（5毫克）和拓扑替康（1毫克）两种药物进行3个周期的IAC治疗。在最近一次就诊时，采用经巩膜三次冻融冷冻疗法作为辅助治疗。最后一次治疗13个月后，RB肿瘤显示为4型消退（扁平脉络膜视网膜瘢痕），未发现复发迹象。
IAC作为一线治疗方法，单独使用或与辅助治疗联合使用，似乎可以使我们挽救患有RB的成年患者的眼球。
