Retinoblastoma

= RETINOBOLASTOMA: = By: Luke Harrie and Katherine Larsen __**Patient History**__: Sally is a 2 year old girl that has crossed eyes, and a visible whiteness in her pupil. She also has poor vision has a white eye glow in photos instead of red. Retinoblastoma is a condition that her father had, and is genetic. They suspect she has the same condition her father did when he was her age. __**Anatomy**__: Originates from the retina. The Pupil and optic nerve may be affected by the tumor in the eye.



Retinoblastoma is a malignant tumor composed of retinoblasts (immature baby cells) in the retina. These cells form the nerve tissues (rods and cones) at the back of the eye. Their job is to form images. The images are then transmitted by the optic nerve to the area of the brain responsible for sight. This condition is rare, except in families that carry RB Gene Mutation.

__**Diagnosis**:__ We diagnosed Sally with Retinoblastoma. She has all the symptoms, and the age is just right. Retinoblastoma usually occurs in children 1-2, it is rarely in children older then 6.




 * __Treatments__**: There are many treatment modalities for this tumor. These are:
 * **Enucleation:** This means removal of the eye. The eye with the tumor is removed and is sent for a pathology report. The space is replaced by an artificial implant made of plastic, rubber or coral. The child is fitted with prosthesis or artificial eye, made to match the other eye. This artificial eye, of course, does not have any vision.
 * **External beam radiation:** as an alternative to enucleation, this method of giving radiation treatment to the eye may treat the tumor while preserving the eye. As the tumor is very radiosensitive, this treatment method is very effective. Though the radiation may cause damage to the surrounding structures of the eye, e.g., lens (cataract), lacrimal system (dry eye), orbit (bone maldevelopment) etc. It also increases the chance of developing secondary tumor of the bone, especially in children with tumor involving both eyes.
 * **Localized Plaque radiation therapy:** This method involves applying radioactive plaque close to the tumor on the sclera, and thus gives the radiation therapy in a localized area. It significantly decreases the local complications associated with radiation therapy.
 * **Photocoagulation:** Laser treatment for the tumor is effective and safe for tumors that are smaller in size. In the right cases, this treatment may help in preserving eye as well as the sight of the child.
 * **Cryotherapy:** this involves freezing of the tumor by applying a special probe on the external surface of the eye (sclera). This treatment is done under direct observation and is effective in saving the eye and sight in patients with small tumor.
 * **Chemotherapy:** Treatment with anticancer drugs. There has been a recent preference towards treatment with systemic drugs as an additional treatment. The chemotherapy may decrease the size of the tumor and thus make it more amenable to local treatment like laser, cryotherapy and plaque radiation.