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Adult onset retinoblastoma: a case report.

Zhang X, Zheng L, Gao F, Dong F - Chin. Med. J. (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

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Adult retinoblastoma is rare, and diagnosis is usually made at a fairly advanced stage... He began to notice floaters in the left eye 1 year before, and was diagnosed with “glaucoma OS” in local hospital... Intraocular pressure (IOP) decreased from 36 mmHg to normal with topical IOP-lowering medication... The patient's visual acuity of the left eye began to decrease in October, 2012... He was diagnosed with “neovascular glaucoma OS” in local hospital, and was advised to have operation... During pre-operative examination, an intraocular mass was found... Fundus examination showed large, whitish, elevated mass lesions with vascular in the inferonasal quadrant of the retina [Figure 1b] and on the disk, with retinal seedings of whitish, nodular lesions [Figure 1c]... As malignant retinal tumor with vitreous seeding of the left eye was diagnosed, the patient was informed sufficiently and decided to receive enucleation... Characteristic manifestation of these adult retinoblastoma was whitish, elevated, vascularized retinal mass with vitreous seeding... In a few cases, the masses involved the whole eye... Diffuse retinoblastoma was also found... In the majority of cases, diagnosis were made at a fairly advanced stage... The majority of the reported retinoblastoma in adults were differentiated showing Flexner-Wintersteiner rosettes... Our patient's tumor was classified as undifferentiated retinoblastoma with no rosettes and fleurettes, so immunohistochemistry was needed for diagnosis.

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Photomicrograph of the enucleated globe showing small undifferentiated cells with hyperchromatic nuclei and scanty cytoplasm (Hematoxylin and Eosin, ×200).
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Figure 2: Photomicrograph of the enucleated globe showing small undifferentiated cells with hyperchromatic nuclei and scanty cytoplasm (Hematoxylin and Eosin, ×200).

Mentions: After topical IOP-lowering medication and intravenous mannitol treatment, IOP OS was out of control. A clinical diagnosis of suspected retinoblastoma was made. As adult cases were rare, diagnostic vitrectomy and retinal lesion biopsy were performed in the left eye on January 29, 2013. Vitreous cytology showed small malignant cells. Histopathological examination of retinal lesion showed small cell neuro endocrine carcinoma. Immunohistochemistry staining: Syn (+), CD56 (NK-1) (+), AE1/AE3 (−), CgA (−), S-100 (−), Desmin (−), Ki-67 (index 8%). As malignant retinal tumor with vitreous seeding of the left eye was diagnosed, the patient was informed sufficiently and decided to receive enucleation. Left globe enucleation and hydroxyapatite orbital implant implantation was performed on Febuary 7, 2013. Histopathological examination showed small cell neuro endocrine carcinoma of the left eye [Figure 2]. Optic nerve and sclera were not involved. Immunohistochemistry staining: CgA (+), Syn (+), NSE (+), CD56 (NK-1) (+), S-100 (−), GFAP (−), HMB45 (−), LCA (−), Melan-A (−), p53 (−), Ki-67 (index 20%). The final diagnosis was undifferentiated retinoblastoma OS.


Adult onset retinoblastoma: a case report.

Zhang X, Zheng L, Gao F, Dong F - Chin. Med. J. (2015)

Photomicrograph of the enucleated globe showing small undifferentiated cells with hyperchromatic nuclei and scanty cytoplasm (Hematoxylin and Eosin, ×200).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837810&req=5

Figure 2: Photomicrograph of the enucleated globe showing small undifferentiated cells with hyperchromatic nuclei and scanty cytoplasm (Hematoxylin and Eosin, ×200).
Mentions: After topical IOP-lowering medication and intravenous mannitol treatment, IOP OS was out of control. A clinical diagnosis of suspected retinoblastoma was made. As adult cases were rare, diagnostic vitrectomy and retinal lesion biopsy were performed in the left eye on January 29, 2013. Vitreous cytology showed small malignant cells. Histopathological examination of retinal lesion showed small cell neuro endocrine carcinoma. Immunohistochemistry staining: Syn (+), CD56 (NK-1) (+), AE1/AE3 (−), CgA (−), S-100 (−), Desmin (−), Ki-67 (index 8%). As malignant retinal tumor with vitreous seeding of the left eye was diagnosed, the patient was informed sufficiently and decided to receive enucleation. Left globe enucleation and hydroxyapatite orbital implant implantation was performed on Febuary 7, 2013. Histopathological examination showed small cell neuro endocrine carcinoma of the left eye [Figure 2]. Optic nerve and sclera were not involved. Immunohistochemistry staining: CgA (+), Syn (+), NSE (+), CD56 (NK-1) (+), S-100 (−), GFAP (−), HMB45 (−), LCA (−), Melan-A (−), p53 (−), Ki-67 (index 20%). The final diagnosis was undifferentiated retinoblastoma OS.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Adult retinoblastoma is rare, and diagnosis is usually made at a fairly advanced stage... He began to notice floaters in the left eye 1 year before, and was diagnosed with “glaucoma OS” in local hospital... Intraocular pressure (IOP) decreased from 36 mmHg to normal with topical IOP-lowering medication... The patient's visual acuity of the left eye began to decrease in October, 2012... He was diagnosed with “neovascular glaucoma OS” in local hospital, and was advised to have operation... During pre-operative examination, an intraocular mass was found... Fundus examination showed large, whitish, elevated mass lesions with vascular in the inferonasal quadrant of the retina [Figure 1b] and on the disk, with retinal seedings of whitish, nodular lesions [Figure 1c]... As malignant retinal tumor with vitreous seeding of the left eye was diagnosed, the patient was informed sufficiently and decided to receive enucleation... Characteristic manifestation of these adult retinoblastoma was whitish, elevated, vascularized retinal mass with vitreous seeding... In a few cases, the masses involved the whole eye... Diffuse retinoblastoma was also found... In the majority of cases, diagnosis were made at a fairly advanced stage... The majority of the reported retinoblastoma in adults were differentiated showing Flexner-Wintersteiner rosettes... Our patient's tumor was classified as undifferentiated retinoblastoma with no rosettes and fleurettes, so immunohistochemistry was needed for diagnosis.

Show MeSH