Sudden dispersion of retinoblastoma shortly after initial chemotherapy treatment.
OBJECTIVE
To present 3 cases of unilateral retinoblastoma that demonstrated unusual tumor dispersion shortly after initial chemotherapy treatment.


METHODS
Observational case series.


METHODS
Review of medical records of patients in whom intraocular dissemination of retinoblastoma occurred after initial treatment with chemotherapy.


RESULTS
Three patients demonstrated an atypical response with intraocular dissemination of retinoblastoma shortly after 1 cycle of chemotherapy. All cases had unilateral retinoblastoma with no vitreous seeding or subretinal fluid at presentation. In 2 cases (Cases 2 and 3), there were a few distant subretinal seeds. Per the International Classification of Retinoblastoma, 1 tumor was group E (Case 1), and the other 2 tumors were group D1 (Cases 2 and 3). In 2 cases (Cases 1 and 2), chemotherapy included a 2-drug regimen of carboplatin and etoposide; in the third case, a 3-drug regimen of carboplatin, etoposide, and vincristine was used. In each case, the retinoblastoma dispersed with tumor cells in the vitreous shortly after initial chemotherapy treatment, leading to subsequent enucleation of the eye.


CONCLUSIONS
Retinoblastoma can exhibit an unexpected and sudden dispersion of the tumor shortly after chemotherapy is initiated.
Parness-Yossifon
Reut
R
Division of Ophthalmology, Children's Memorial Hospital, Chicago, Illinois, USA. gilhut1@gmail.com
Bryar
Paul J
PJ
Weinstein
Joanna L
JL
Srikumaran
Divya
D
Mets
Marilyn B
MB
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002675:Child, Preschool; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D015353:Eye Enucleation; D005134:Eye Neoplasms / Q000556:secondary*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009366:Neoplasm Seeding; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D012175:Retinoblastoma / Q000188:drug therapy / Q000556:secondary*; D014750:Vincristine / Q000009:adverse effects; D014822:Vitreous Body
D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin