Histopathological Analysis of Retinoblastoma at Tertiary Care Ophthalmic Centre
Keywords:Retinoblastoma, intraocular tumour, Choroid invasion; Optic nerve invasion, degree of differentiation, high risk factors
Introduction: Retinoblastoma is the most common intraocular tumour of childhood. The incidence has been estimated to be 1 in 15,000 to 1 in 34,000 births. All races and both sexes are affected equally Unilateral (70%) or bilateral (30%). Sporadic (60%) or familial (40%). The mean age at diagnosis is 18 months, and about 90% of cases are diagnosed before 3 years of age
Objectives: • Aim of this study is find out incidence rate of retinoblastoma from at M. J Institute tertiary care ophthalmic centre, civil hospital, Ahmedabad.
• Histopathological analysis for to establish relationship between age, degree of differentiation and high risk features.
• Histopathological analysis is essential for early diagnosis, treatment, improve prognosis, reduce morbidity and mortality.
Material & Method: 41 enucleated eyes received out of 41 prospectively registered case from june-2017 to june-2019 were included in study which was carried out at histopathology department, M.J western regional institute of ophthalmology, civil hospital Ahmedabad. Histopathological findings were evaluated according to age, sex, laterality, extent of invasion into vitreous, choroid, sclera, optic nerve, surrounding tissue, necrosis, calcification, degree of differentiation. Grading and staging were performed according to 8th AJCC classification of eye tumour.
Results: Out of 41 eyes, 11(26.83%) cases were under 2 year of age and 30(73.17%) cases were above 2 year of age. 23(56.1%) cases were female and 18(43.90%) cases were male, 19(46.34%) cases were found in right eye, 22(53.66%) cases were found in left eye , all cases were unilateral, vitreous seeding was observed in 33 (80.49%) cases, Choroid invasion was observed in 36(87.80%) cases, Optic nerve involvement was observed in 16(39.02%) cases, Necrosis and Calcification were observed in 31(75.60%) and 28 (68.90%) cases respectively. 20(48.78%) cases were found in pathological stage pT3 .
Conclusion: Rosettes, Necrosis and calcification were commonly observed findings in the study. Optic nerve and choroidal invasion were important prognostic factors for staging, prognosis and patient outcome. High incidence of pathological stage pT3 and poorly differentiated tumours were observed in this study. This could be due to late age of diagnosis.