Mietz H, Hutton W L, Font R L
Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
Ophthalmology. 1997 Jan;104(1):43-7. doi: 10.1016/s0161-6420(97)30363-7.
The authors report the clinical, cytologic, and histopathologic findings of a unilateral retinoblastoma occurring in a 26-year-old woman. This tumor usually affects young children; the mean age at the time of diagnosis usually ranges from 10 to 25 months.
Histopathologic examination of the enucleated right eye included using standard techniques, as well as immunohistochemical stains of formalin-fixed, paraffin-embedded tissues.
Histologic examination of sections of the eye showed a retinal tumor that was centered in the equatorial region and had the typical features of a poorly differentiated retinoblastoma. Focal choroidal invasion and seeding of the anterior and posterior chambers were observed. Immunoreactivity of the tumor cells for neuron-specific enolase confirmed that the tumor is a neuronal neoplasm consistent with retinoblastoma.
Retinoblastoma occurring in adults is a rare finding. In most large series of retinoblastomas, no adults are included. Only eight patients 20 years of age or older with retinoblastomas have been documented previously. In the current case, the patient had no evidence of orbital recurrence or metastasis 6 years after enucleation of the eye. It may be important for clinicians to consider this diagnosis when confronted with a retinal mass of unknown etiology in adults.
作者报告了一名26岁女性发生的单侧视网膜母细胞瘤的临床、细胞学和组织病理学检查结果。这种肿瘤通常影响幼儿；诊断时的平均年龄通常在10至25个月之间。
对摘除的右眼进行组织病理学检查，采用标准技术，并对福尔马林固定、石蜡包埋的组织进行免疫组化染色。
眼部切片的组织学检查显示视网膜肿瘤，以赤道区为中心，具有低分化视网膜母细胞瘤的典型特征。观察到局部脉络膜侵犯以及前房和后房播散。肿瘤细胞对神经元特异性烯醇化酶的免疫反应性证实该肿瘤是与视网膜母细胞瘤一致的神经元肿瘤。
成人发生视网膜母细胞瘤是一种罕见的情况。在大多数大型视网膜母细胞瘤系列研究中，未纳入成人病例。此前仅记录了8例20岁及以上患有视网膜母细胞瘤的患者。在当前病例中，患者在眼球摘除6年后没有眼眶复发或转移的证据。对于临床医生而言，在面对成人不明病因的视网膜肿物时考虑这一诊断可能很重要。
