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A Histopathological Analysis of Retinoblastomas Enucleated after Neoadjuvant Chemotherapy 1. Seema Kashyap¹ ¹Ocular Pathology Services, DR R P CENTRE, AIIMS, New Delhi, India Purpose: Retinoblastoma is the most common primary intraocular malignancy in children. Overt extraocular disease (Stage III; International retinoblastoma staging) is treated with neoadjuvant chemotherapy to reduce tumor size so that enucleation can be carried out and the complications associated with exenteration are avoided. Herein, we have analysed the histopathological findings in eyes enucleated after receiving neoadjuvant chemotherapy. Methods: Retrospective analysis of retinoblastoma cases enucleated after 3 cycles neoadjuvant chemotherapy over a period of 7 years (January 2003 to December 2009). Only those cases with optic nerve thickening and /or presence of extraocular mass on imaging were included. Haematoxylin and eosin stained sections were evaluated for histopathological parameters. Results: There were a total of 85 eyes; mean age 3.15±1.45 years. Thirty one (36.5%) eyes were phthisical and 11 (12.9%) had almost completely regressed tumour with very few viable cells. There were 77 (89.4%) eyes with poorly differentiated tumors. There were 10.6% cases with post laminar optic nerve invasion, 16.5% with invasion of resected margin of optic nerve, 24.7% with massive choroidal invasion, 22.4% with invasion of sclera, 14.1% iris, 10.6 % ciliary body, 16.5% anterior chamber and 9.4% extraocular. There were 26 (30.6%), 41 (48.2%) and 41 (48.2%) cases with extensive necrosis, minimal necrosis and calcifications respectively. Conclusion: Chemotherapy has a variable effect on eyes with retinoblastoma. A considerable amount of tumor load is decreased post chemotherapy. When enucleated after receiving 3 cycles of chemotherapy, about 75% of eyes with pre-operative gross extraocular invasion had no histopathological evidence of residual disease. |
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