Histopathologic Findings of Eyes Enucleated After Treatment with Chemosurgery for Retinoblastoma
Carolyn P Graeber 1, 2, Y. Pierre Gobin 1, 3, Brian P Marr 1, Ira J Dunkel 1, Scott E Brodie 1, 4, Norbert Bornfeld 5, Devron H Char 6, Robert Folberg 7, Saskia M Imhof 8, Amy Y Lin 9, Jesse L Berry 1, 10, Saleh Al Mesfer 11, Annette C Moll 12, David H Abramson*, 1
Identifiers and Pagination:Year: 2011
First Page: 1
Last Page: 5
Publisher Id: TOOPHTJ-5-1
Article History:Received Date: 4/8/2010
Revision Received Date: 30/8/2010
Acceptance Date: 26/11/2010
Electronic publication date: 18/1/2011
Collection year: 2011
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Intra-arterial chemotherapy (chemosurgery) for the treatment of retinoblastoma has been performed more than 1600 times (more than 1400 times in Japan and 200 times in New York) over the past 20 years.Despite this treatment’s success some eyes cannot be saved and require enucleation. Here we report the histopathologic findings of the remaining intraocular tumor of eyes that were enucleated following treatment that included chemosurgery in New York City.
Materials and Methodology:
Independent histopathologic review of the enucleated eyes was correlated with the clinical findings that prompted enucleation.
Between May 1, 2006 and April 30, 2009, 56 eyes received chemosurgery at our institution, and 10 of these were enucleated subsequently. All were Reese Ellsworth Group 5 at enucleation. Of the 21 eyes that were treated with chemosurgery as the primary treatment, 1 (5%) was enucleated subsequently; its histopathology revealed residual non-necrotic, non-calcified tumor. Of the 34 eyes treated with chemosurgery after other treatments, 9 (24%) were enucleated, and 5 of these eyes contained non-calcified, non-necrotic tumor. None was enucleated for complications of chemosurgery. All patients were alive and free of metastatic disease as of September 2009.
A significant number of eyes with advanced intraocular retinoblastoma avoided enucleation as a result of chemosurgery. The rate of eyes that were enucleated was higher when chemosurgery was the secondary rather than the primary treatment. Of the eight eyes enucleated for progressive disease six had non-necrotic, non-calcified tumor cells.