title: Chiasmatic infiltration secondary to late malignant transformation of retinoma.
abstract: OBJECTIVE
  To report the lethal course of malignant transformation of retinoma in an adult.
  
  
  METHODS
  Case report. A 40-year-old patient presented with retinoma in his right eye and retinoblastoma in his left eye. Enucleation was recommended but refused and the patient received whole eye radiotherapy elsewhere. Five years later he presented again, with temporal hemianopsia of the left eye secondary to chiasmatic invasion.
  
  
  RESULTS
  Diagnosis of retinoblastoma infiltration was confirmed by stereotactic biopsy of the chiasmatic lesion. Treatment with intravenous and intrathecal chemotherapy led to partial remission, and was followed by stereotactic irradiation of the chiasmatic mass and right optic nerve. The left eye was enucleated. Death occurred one year later due to cerebrospinal fluid metastases.
  
  
  CONCLUSIONS
  Extraocular extension of retinoblastoma diagnosed in adulthood has never, to our knowledge, been reported. This case stresses the importance of lifelong retinoma monitoring and the necessity for radical treatment in the event of malignant transformation.
authors.affiliation: Jules Gonin Eye Hospital, Av.de France 15, 1004 Lausanne, Switzerland.
authors.forename: Asimina
authors.initials: A
authors.lastname: Mataftsi
authors.forename: Leonidas
authors.initials: L
authors.lastname: Zografos
authors.forename: Aubin
authors.initials: A
authors.lastname: Balmer
authors.forename: Sylvie
authors.initials: S
authors.lastname: Uffer
authors.forename: Roger
authors.initials: R
authors.lastname: Stupp
authors.forename: Robert C
authors.initials: RC
authors.lastname: Janzer
authors.forename: Alessia
authors.initials: A
authors.lastname: Pica
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Schorderet
authors.forename: Francis L
authors.initials: FL
authors.lastname: Munier
mesh_terms: D000328:Adult; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D015353:Eye Enucleation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009897:Optic Chiasm / Q000473:pathology*; D019574:Optic Nerve Neoplasms / Q000473:pathology*; D011230:Precancerous Conditions / Q000473:pathology*; D019572:Retinal Neoplasms / Q000235:genetics / Q000473:pathology*; D012175:Retinoblastoma / Q000235:genetics / Q000473:pathology*; D016160:Retinoblastoma Protein / Q000235:genetics; D014057:Tomography, X-Ray Computed
chemical_list: D016160:Retinoblastoma Protein