Retinoblastoma morphology after local chemotherapy

    Abstract

    Retinoblastoma morphology after local chemotherapy

    S.V. Saakyan, I.P. Khoroshilova-Maslova, S.S. Tadevosyan, A.Yu. Tsygankov, G.P. Zakharova, O.A. Ivanova, A.A. Zharua

    Helmholtz National Medical Research Center of Eye Diseases, Moscow
Eye Clinic of Dr. Belikova, Moscow

    Purpose. Determine the nature of tumor regression and possible complications associated with the retinotoxic effect of melphalan and carboplatin with local chemotherapy in combination with systemic chemotherapy.

    Methods. A histological analysis of 19 enucleated eyes from 19 patients with retinoblastoma was performed after combined organ-preserving treatment, including systemic chemotherapy and local chemotherapy in various doses.

    Results. Complete regression of the tumor was detected in 3 out of 19 eyes, partial in 13 eyes. There were no signs of regression in 3 eyes. Tumor invasion into the choroid was found in 5 cases, into the anterior sector - in 3 cases, into the optic nerve – in 3 cases. The retrobulbar tumor was presented in 1 case. Hemorrhagic changes associated with necrosis of the vascular wall during intraarterial chemotherapy and destruction of retinal pigment epithelium, leading to atrophic processes in the retina, were revealed.

    Conclusions. Retinoblastoma can be controlled with local chemotherapy, but morhology of enucleated eyes reveals ocular complications, including severe vascular complications, fibrosis, glaucoma and the possibility of persisting vital tumour cells. Cases in which therapeutic pathomorphosis has not been identified should be attributed to resistant forms of retinoblastoma.

    Key words: retinoblastoma, morphology, chemotherapy.