Unusual echographic form of retinoblastoma

Echography of retinoblastoma: histopathologic correlation and serial evaluation after globe-conserving radiotherapy or chemotherapy

PURPOSE

To assess the sensitivity of echography in detecting retinoblastoma, compare tumor features observed by echography with histopathology data, and assess the usefulness of echography in serially following retinoblastoma tumors after globe-conserving treatments.

METHODS

The medical and echography records of all patients treated for retinoblastoma at the Bascom Palmer Eye Institute between 1991 and 1997 were reviewed. All eyes underwent pretreatment echographic evaluation, and eyes treated with external beam radiotherapy, brachytherapy, or chemotherapy underwent serial follow-up echography.

RESULTS

Sixty-nine eyes of 48 patients were identified. Echography demonstrated evidence of retinoblastoma in 69 of 69 (100%) eyes and calcification in 63 (91.3%) eyes. Histopathology was superior to echography in detecting optic nerve invasion, extraocular extension, and presence of calcification.

CONCLUSION

Echography is a useful adjunct to indirect ophthalmoscopy in establishing the diagnosis of retinoblastoma. While not as specific as histopathology, echographic evaluation before and after treatment of retinoblastoma permits monitoring of treatment response and may aid in detecting recurrent tumor growth or failure to respond to treatment.

Ultrasonic findings in intraocular retinoblastoma and correlation with histopathologic diagnosis

A and B-scan ultrasonographic records of 132 eyes of 126 patients with suspected retinoblastoma were evaluated retrospectively. Six patients had bilateral lesions. The results were compared with the histopathologic diagnoses obtained after enucleation in 129 cases and with the indirect ophthalmoscopic examination in 3 bilateral cases. Ultrasonographic diagnosis was correct in 115 cases (87.12%), false-negative in 12 cases (9.09%) and false-positive in 5 cases (3.79%). Echographic tumor typing was made in 88 cases and the mixed tumor type was the most frequent with 74 cases (84.09%). Cystic, solid and diffuse infiltrating types were the other echographic diagnoses. Our experience confirms the accuracy of ultrasonography in the diagnosis of retinoblastoma.