Clinical analysis of 20 cases of retinoblastoma without calcification on CT scan / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the clinicopathologic characteristics,treatment and prognosis of retinoblasto-ma without calcification.Methods The clinic and pathologic data of 20 cases of retinoblastoma without calcification were analyzed retrospectively.All the cases were selected from 710 cases of retinoblastoma archived in Beijing Tongren Hospital,Capital Medical University from April 2010 to April 2015.The inclusion criteria was no calcification on CT scan before treatment.The patients after enuclea-tion were diagnosed according to pathology;the patients without enu-cleation were diagnosed according to clinical manifestations,Retcam fundus,ophthalmic ultrasound and the reduction of tumor after chemotherapy.The clinical features,treatment and prognosis were summarized through statistical analysis of the 20 cases.The patients were followed -up through clinical reexamination and telephone calls.Results In this study,there were 14(70.0%)male and 6(30.0%)female patient′s;there were 19 cases(95.0%)less than 5 -year -old,14 cases (70.0%)less than 3 -year -old,1 case (5.0%)less than 1 -year -old.Eighteen cases (90.0%)were unilateral disease,and 2 cases (10.0%)were bilateral disease.According to international Intraocular Retinoblastoma Classification stage4 cases (18.2%)in stage E ,17 cases (77.3%)in stage D ,1 case (4.5%)in stage C.Five cases (25.0%)were enucleated eyes,and pathology report was retinoblastoma.Nine cases (45.0%) were treated with pre -enucleation chemotherapy,and finally enucleated after poor tumor shrinkage or recurrence,and the pathology was retinoblastoma.Five cases (25.0%)without enucleation were stable.One case (5.0%)failed to follow -up owing to the patients irregular treatment.In 14 enucleation cases,histopathologic high risk factors could be found in 3 cases (21 .4%),and couldn′t be found in the other 11 cases (78.6%).In the cases that were not enuclea-ted,the tumor diminished in size or new calcification presented in the fundus examination,and in 12 cases,new calcifi-cation was pre-sented on follow -up CT scan.Follow -up failed in 1 case(5.0%),but follow -up was available for 19 cases,and among them 13 cases (68.4%)were disease -free survival and 6 cases (31 .6%)were alive with tumor. Conclusions Close attention should be paid to the untypical retinoblastoma with no calcification on CT scan through well -taken medical history and meticulous imaging examination,in order to give early diagnosis and therapy.