Emily Zolfaghari1,2, Jonathan W Kim1,2, Subramanian Krishnan2, Patricia Chévez-Barrios3,4,5,6,7, Jesse L Berry1,2. 1. The Vision Center at Children's Hospital Los Angeles, CA, USA. 2. USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. 3. Department of Pathology and Genomic Medicine, Houston Methodist Hospital, University of Texas, MD Anderson Cancer Center, Houston, TX, USA. 4. Retinoblastoma Center of Houston, Baylor College of Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Ophthalmology, Baylor College of Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA. 6. Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, University of Texas, MD Anderson Cancer Center, Houston, TX, USA. 7. Department of Pathology and Laboratory Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Abstract
BACKGROUND: Recurrences of retinoblastoma tumors, particularly scar recurrences, are a common phenomenon in the management of this cancer. Consolidative treatment with laser and cryotherapy are required for local control of disease. It is known that consolidative therapy can induce retinal pigment epithelium (RPE) hyperplasia and gliosis. Herein we report extensive RPE hyperplasia and gliosis during laser therapy for a focal scar recurrence, which presented as a progressive retinal opacification mimicking active retinoblastoma. METHOD: This is a retrospective case review. RESULTS: A 2-month-old premature male was diagnosed with sporadic bilateral retinoblastoma (International Intraocular Retinoblastoma Classification [IIRC] group B in the right eye and IIRC group A in the left eye). The patient underwent laser therapy for a focal recurrence which demonstrated a white lesion during therapy and was subsequently enucleated. While there was a focal recurrence and infiltration of the retina (seen both on optical coherence tomography and histopathologic section), the majority of the white, progressive lesion was from extensive RPE hyperplasia and gliosis secondary to laser therapy. CONCLUSION: Clinicopathologic correlation of the active recurrence and adjacent gliosis is demonstrated.
BACKGROUND: Recurrences of retinoblastoma tumors, particularly scar recurrences, are a common phenomenon in the management of this cancer. Consolidative treatment with laser and cryotherapy are required for local control of disease. It is known that consolidative therapy can induce retinal pigment epithelium (RPE) hyperplasia and gliosis. Herein we report extensive RPE hyperplasia and gliosis during laser therapy for a focal scar recurrence, which presented as a progressive retinal opacification mimicking active retinoblastoma. METHOD: This is a retrospective case review. RESULTS: A 2-month-old premature male was diagnosed with sporadic bilateral retinoblastoma (International Intraocular Retinoblastoma Classification [IIRC] group B in the right eye and IIRC group A in the left eye). The patient underwent laser therapy for a focal recurrence which demonstrated a white lesion during therapy and was subsequently enucleated. While there was a focal recurrence and infiltration of the retina (seen both on optical coherence tomography and histopathologic section), the majority of the white, progressive lesion was from extensive RPE hyperplasia and gliosis secondary to laser therapy. CONCLUSION: Clinicopathologic correlation of the active recurrence and adjacent gliosis is demonstrated.
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