Tejal Magan1, Chloe T L Khoo, Pascal M Jabbour, Carol L Shields. 1. *Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania; †St George's, University of London, London, United Kingdom; ‡Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; and §Division of Neurovascular and Endovascular Surgery, Neurosurgery Department, Thomas Jefferson University, Philadelphia, Pennsylvania.
Abstract
PURPOSE: Intraarterial chemotherapy for retinoblastoma is usually reserved for infants aged 3 months or older because of the intricacy of the newborn vascular anatomy making the procedure technically challenging. The authors report a successful case of intraarterial chemotherapy performed in a 2-month-old infant using a minimal exposure approach. METHODS: Case report. RESULTS: A 2-month-old infant presented with leukocoria and was subsequently diagnosed with an exophytic Group D retinoblastoma in the right eye. The infant received melphalan 3 mg delivered into the ostium of the ophthalmic artery of the right eye under fluoroscopic guidance. Examination under anesthesia a month later showed complete tumor regression to a calcified Type I scar. After a second cycle of intraarterial chemotherapy, no further treatment was necessary. There were no complications. CONCLUSION: Intraarterial chemotherapy is generally used for retinoblastoma in infants aged 3 months or older. The patient was successfully catheterized and treated at 2 months of age, with complete tumor regression after a single chemotherapy dose. Thus, in expert hands, intraarterial chemotherapy can be considered in such young infants.
PURPOSE: Intraarterial chemotherapy for retinoblastoma is usually reserved for infants aged 3 months or older because of the intricacy of the newborn vascular anatomy making the procedure technically challenging. The authors report a successful case of intraarterial chemotherapy performed in a 2-month-old infant using a minimal exposure approach. METHODS: Case report. RESULTS: A 2-month-old infant presented with leukocoria and was subsequently diagnosed with an exophytic Group D retinoblastoma in the right eye. The infant received melphalan 3 mg delivered into the ostium of the ophthalmic artery of the right eye under fluoroscopic guidance. Examination under anesthesia a month later showed complete tumor regression to a calcified Type I scar. After a second cycle of intraarterial chemotherapy, no further treatment was necessary. There were no complications. CONCLUSION: Intraarterial chemotherapy is generally used for retinoblastoma in infants aged 3 months or older. The patient was successfully catheterized and treated at 2 months of age, with complete tumor regression after a single chemotherapy dose. Thus, in expert hands, intraarterial chemotherapy can be considered in such young infants.
Authors: A Sweid; B Hammoud; J H Weinberg; P Texakalidis; V Xu; K Shivashankar; M P Baldassari; S Das; S Ramesh; S Tjoumakaris; C L Shields; D Ancona-Lezama; L-A S Lim; L A Dalvin; P Jabbour Journal: AJNR Am J Neuroradiol Date: 2020-06-25 Impact factor: 3.825
Authors: Fairooz P Manjandavida; Christina Stathopoulos; Jing Zhang; Santhosh G Honavar; Carol L Shields Journal: Indian J Ophthalmol Date: 2019-06 Impact factor: 1.848