Retinoma: spontaneous regression of retinoblastoma or benign manifestation of the mutation?

Non-progressive retinal lesions, observed in patients known to carry the gene for retinoblastoma, have in the past been called "spontaneous regression" of retinoblastoma. This term suggests shrinkage of a malignant growth, perhaps in response to some host defence mechanism. On the basis of observations on 30 patients, we propose that the term "retinoma" would be less presumptive and more suitable. Retinoma is clinically defined as a translucent, grey, elevated mass extending into the vitreous from the retina, frequently associated with calcified foci and pigment-epithelium hyperplasia. The diagnosis of retinoma strongly suggests the presence of the retinoblastoma gene, necessitating genetic counselling and frequent observation of the retinas in the individual and his offspring. We suggest that the same mutations can cause either retinoma or retinoblastoma: benign hyperplastic nodules or retinoma when the mutations occur in relatively mature retinoblasts; and malignant retinoblastoma when the same mutations arise in immature retinoblasts.