Question
A child presents with Squint and Deterioration of Vision.On examination of the eye,following picture is seen.On ophthalmoscopic examination,a nodular cream colored mass with increased vascularization is seen.On histopathological examination of the mass,Rossetes are seen.On CT scan-large heterogeneous posterior chamber mass with calcifications ,filling >50% of the globe is seen.Current therapy of this condition would involve ?
A. Enucleation.
B. Chemotherapy followed by local dyes.
C. Direct Laser ablation using photo dynamic cryotherapy.
D. Scleral radiotherapy followed by chemotherapy.
Show Answer
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Correct Answer » A
Explanation
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Ans:A. Enucleation
The patient is suffering from Retinoblastoma.
The International Classification for Intraocular Retinoblastoma :
- Group A: Small intraretinal tumors (< 3mm) away from foveola and disc.
- Group B: Tumors > 3mm, macular or juxtapapillary location, or with subretinal fluid.
- Group C: Tumor with focal subretinal or vitreous seeding within 3mm of tumor.
- Group D: Tumor with diffuse subretinal or vitreous seeding > 3mm from tumor.
- Group E: Extensive retinoblastoma occupying >50% of the globe with or without neovascular glaucoma, hemorrhage, extension of tumor to optic nerve or anterior chamber.
Treatment:
- Focally destructive therapy (cryopexy, laser photocoagulation, hyperthermia and plaque irradiation) for small tumors.
- Primary neoadjuvant chemotherapy or chemoreduction by vincristine, high-dose carboplatin, and etoposide -the principle mode of treatment for eyes in intraocular groups C and D.
- Eyes with large tumor burden (Group E ) and eyes that progress despite conservative treatments require enucleation.
