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
1 Memorial Sloan-Kettering Cancer Center, New York, NY, USA
2 New York University School of Medicine/Manhattan Eye, Ear & Throat Hospital, New York, NY, USA
3 New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY, USA
4 Mount Sinai Hospital, New York, NY, USA
5 University of Duisburg-Essen, Essen, Germany
6 Stanford University, Stanford, CA, USA
7 Oakland University William Beaumont School of Medicine, Rochester, MI, USA
8 University Medical Center, Utrecht, The Netherlands
9 University of Illinois at Chicago, Chicago, IL, USA
10 Doheny Eye Institute, Los Angeles County Medical Center, Los Angeles, CA, USA
11 King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
12 VU University Medical Center, Amsterdam, The Netherlands

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© Graeber et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Memorial Sloan-Kettering Cancer Center, 1233 York Ave, Rm 311, New York, NY 10065, USA; Tel: 212-639-7232; Fax: 212-734-2553; E-mail:



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.

Keywords: Retinoblastoma, histopathology, chemosurgery.