Fetal antigens in retinoblastoma

Significance of carcinoembryonic antigen in retinoblastoma

The role of estimating the serum carcinoembryonic antigen (CEA) in the diagnosis and prognosis of retinoblastoma cases has been evaluated. Although the mean serum CEA titre in children with retinoblastoma was higher than that in control children (p = 0.01), the serum CEA level itself was found not to be a useful marker in the diagnosis of retinoblastoma. A significant correlation of serum CEA titre with progression or regression of the disease observed during therapy in most cases indicated that serial assays of serum CEA may be important in the follow-up of cases with retinoblastoma. The lower CEA values in aqueous humour and subretinal fluid from eyes with retinoblastoma than in the serum suggests that the tumour does not secrete the CEA.

Cytotoxic activity of lymphocytes from F 344 rats bearing intraocular tumor derived from human adenovirus 12-induced retinoblastoma-like cell line

Lymphocyte cytotoxicity using 51Cr releasing assay was investigated in 10 F344 rats bearing intraocular tumor derived from human adenovirus 12 (Ad 12)-induced retinoblastoma -like cell line (EXP-5). Lymphocytes obtained from tumor bored animal (1 X 10(6)/well) incubated with 51Cr-labelled EXP-5 cells (1 X 10(5)/well) for 24 hours, and counted by beta-scintillation counter. The cytotoxic activity of lymphocytes of transplanted animals was higher in 3 out of 10 subjected rats (24-30%) than in 10 rats of control (3-5%). The results support the view that the correspond animal model in its resemblance and suggested that the rats with retinal tumor have concomitant cell-mediated immunity in the early stage of tumor bearing.

Ocular toxocariasis. A review

This review is an update on the subject of ocular toxocariasis. An introductory section is designed to familiarize the clinician with the epidemiology, characteristics of the organism, the life cycle in dogs and the systemic human disease known as visceral larval migrans ( VLM ). The more comprehensive second section considers the historical aspects of the ocular involvement, the clinical variations of ocular toxocariasis, pathology, differential diagnosis, diagnostic approaches, and treatment. Emphasis is placed upon new diagnostic techniques such as the enzyme-linked immunosorbent assay (ELISA) and cytologic diagnosis of intraocular aspirates. Newer therapeutic techniques such as vitrectomy are also considered. The review includes 200 references on systemic and ocular toxocariasis.

Carcinoembryonic antigen in retinoblastoma. An immunohistochemical study

Pathological amounts of carcinoembryonic antigen (CEA) have earlier been reported in the plasma of patients with retinoblastoma, and it has been suggested that CEA determinations be used in the follow-up of treatment of these patients. In the present study, 47 retinoblastoma specimens from the years 1962-1982 were examined. These specimens represented different clinical and pathological tumour types. Colon adenocarcinomata positive for CEA were used as controls. The laboratory method was a highly sensitive immunohistochemical peroxidase-staining procedure. By this method, CEA was not found in any of the retinoblastomata examined. It is probable that retinoblastoma does not produce CEA, but in theory it may indirectly increase the CEA titre or, on the other hand, be fully independent of CEA. Only after this relationship has been thoroughly clarified can determinations of plasma CEA in patients with retinoblastoma be used in clinical work.

Spontaneous regression of bilateral retinoblastoma

A 24-year-old black man was found to have bilateral, spontaneously regressed retinoblastoma that had previously been misdiagnosed as post-traumatic chorioretinal scarring. His son and half-brother both had bilateral viable retinoblastoma. The ophthalmoscopic and fluorescein angiographic features of this patient's fundus lesions included a calcified, whitish mass located centrally in one of the scars and a fine residual vascularity in another of the fundus lesions. The authors review the pertinent literature on spontaneous regression of retinoblastoma.

Family study of serum carcinoembryonic antigen in inherited medullary carcinoma of the thyroid

Serum carcinoembryonic antigen (CEA) and calcitonin were assayed in 8 patients with medullary carcinoma of the thyroid (MCT) and 14 unaffected family members, from 4 pedigrees of Sipple's syndrome and one pedigree with inherited MCT. Serum CEA ranged from 5.4 to 44.5 ng/ml in the patients, but less than 2.5 ng/ml in the unaffected. This is in contrast with retinoblastoma and cancer family syndrome, where not only the patients but also unaffected family members show high serum CEA, and cytoplasmic or selective maternal inheritance of serum CEA level is presumed. In inheritable MCT, serum CEA increases in association with the development of MCT, and serum CEA level per se is not inherited.

Carcinoembryonic antigen (CEA) levels in patients with brain tumours

Plasma and cerebrospinal fluid CEA determination was done in 97 patients with neurosurgical disorders. Elevated titres were found in 14 of 64 patients with brain tumours. CEA levels were elevated significantly in patients with metastatic brain tumours. Following treatment, the values fell in three patients with ependymoma, medulloblastoma, and unverified brain tumour. This study suggests that CEA levels may be of value in the differential diagnosis of primary and metastatic brain tumours, and useful in the evaluation of patients with brain tumours after treatment. CEA in the cerebrospinal fluid was absent in eight patients with brain tumours.

Retinoblastoma

Retinoblastoma is a radiosensitive malignancy of neuroblastic origin that primarily affects young children. Its relatively low incidence belies its potential importance in the understanding of tumor biology in general. A case is made for referral of all retinoblastoma patients to centers with retinoblastoma protocols.

Metastatic retinoblastoma of the mandible

Two cases of oral metastasis of retinoblastoma are reported. The first case was seen in Iraq and the second case in England. Review of the literautre revealed that when oral metastasis occurs, the prognosis must be considered to be grave; this was confirmed by Case 2. In each case there was metastasis in the symphyseal region, which followed enucleation of the affected orbit. Although the prognosis is poor, recent studies indicate that immunologic techniques may be useful to monitor the response to treatment of the primary lesion.

Human alpha-fetoprotein in the epidermal cells of Bowen's disease

Human alpha-fetoprotein (HAFP) was demonstrated in clusters of atypical cells of an extensive Bowen's disease involving the pubic area. Frozen sections were studied by indirect immunofluorescence using monospecific rabbit anti-HAFP antiserum or purified rabbit anti-HAFP antibody followed by staining with fluorescein isothiocyanate (FITC)-labeled goat anti-rabbit gamma-globulin and by a direct technique using FITC-labeled rabbit anti-HAFP Fab2 fragments. Sections of fetal liver served as positive controls and sections of adult human skin and liver were used as negative controls. Preabsorption of the anti-HAFP antibodies with purified HAFP blocked the fluorescence. This finding adds Bowen's disease to the list of premalignant disorders which possess HAFP as an oncofetal marker of their malignant potential. HAFP might possibly enhance malignant behavior through interference with cellular immunosurveillance mechanisms.

Aqueous cytology and enzymes in nematode endophthalmitis

A 7-year-old girl had a white fundus mass and vitreous cells, compatible with an endophytic retinoblastoma. Aqueous aspiration revealed normal lactate dehydrogenase levels and large numbers of eosinophils, suggesting the diagnosis of nematode endophthalmitis. Treatment with corticosteroids brought about resolution of the inflammation and an excellent visual result.

Current approaches to the diagnosis and management of choroidal melanomas

Although malignant melanoma of the uveal tract is well known as the most common primary intraocular malignancy, many questions exist regarding the best approach to its diagnosis and treatment. In the past, diagnosis has been made by direct ophthalmoscopy alone and errors resulting in unnecessary enucleation have been frequent. However, recent studies have shown that the adequate use of new techniques such as indirect ophthalmoscopy, fluorescein angiography, ultrasonography, and the 32P test can reduce the incidence of error substantially. A 12-step procedure for diagnosis utilizing these aids is outlined. Traditionally, enucleation has been accepted as the treatment of choice. However, with earlier and more accurate diagnosis, alternative treatments are being applied in selected cases. Although photocoagulation, irradiation, cryotherapy, diathermy and local resection of choroidal melanomas have been used with some success, these methods require further trial and followup before their value can be established. Techniques and indications for use of these procedures are discussed, and the complications and potential effectiveness of each is evaluated.

CEA family syndrome. Abnormal carcinoembryonic antigen (CEA) levels in asymptomatic retinoblastoma family members

Plasma carcinoembryonic antigen (CEA) levels were studied in all available members of 17 families in which a presumed sporadic retinoblastoma had occurred. In 9 of the 17 families, close relatives of the patient had elevated CEA levels in the absence of demonstrable disease; this we have termed the "CEA family syndrome." In two families (Nos. 8 and 17) one or both parents and all of the siblings had elevated CEA levels. To our knowledge, this is the first report of abnormal CEA levels in unaffected family members of patients with nonadenocarcinoma-type malignancies. As follow-up studies of such families become available, detection of the "CEA family syndrome" may prove to be a useful means of locating individuals with inherited premalignant or malignant conditions and may provide a stimulus for additional clinical examination of asymptomatic individuals considered at risk for developing malignancies.