Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma
Abstract Background Retinoblastoma is considered the most common intraocular malignancy in childhood, comprising 4% of all pediatric cancers. Management of retinoblastoma has evolved over the past two decades and intra-ophthalmic artery chemotherapy has emerged as a new modality of globe-conserving...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | International Journal of Retina and Vitreous |
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| Online Access: | http://link.springer.com/article/10.1186/s40942-017-0083-x |
| _version_ | 1819330633995911168 |
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| author | Camila V. Ventura Audina M. Berrocal Jennifer Thomson Fiona J. Ehlies Azeema Latiff Timothy G. Murray |
| author_facet | Camila V. Ventura Audina M. Berrocal Jennifer Thomson Fiona J. Ehlies Azeema Latiff Timothy G. Murray |
| author_sort | Camila V. Ventura |
| collection | DOAJ |
| description | Abstract Background Retinoblastoma is considered the most common intraocular malignancy in childhood, comprising 4% of all pediatric cancers. Management of retinoblastoma has evolved over the past two decades and intra-ophthalmic artery chemotherapy has emerged as a new modality of globe-conserving treatment with excellent results. This treatment achieves effective tumor reduction by delivering localized chemotherapy, decreases enucleation rate, and minimizes systemic and local side effects. Case presentation We report the case of an 8-year-old girl with a late presentation of an advanced unilateral retinoblastoma associated to diffuse exudative retinal detachment in the right eye, classified as group E by the International Classification of Retinoblastoma. The initial therapeutic proposal for the patient was five sessions of intra-ophthalmic artery chemotherapy (IAC) associated to large spot diode laser therapy. After undergoing four sessions of IAC, the fundus exam revealed a giant retinal tear associated to a total retinal detachment in the affected eye. The IAC treatment was concluded and enucleation was considered the best treatment option at that moment, since IAC was unable to control the tumor’s activity and the patient’s eye presented with a complex rhegmatogenous retinal detachment (RRD). However, family left for a second opinion and never returned. Conclusions The usage of IAC for retinoblastoma management may lead to important local complications. Despite rare, RRD secondary to IAC may occur. We postulate that the giant tear observed in this case was caused by the rapid tumor necrosis using this route of treatment. |
| first_indexed | 2024-12-24T14:01:38Z |
| format | Article |
| id | doaj.art-1bae61814a0f418f97a3729ce3916116 |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-12-24T14:01:38Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-1bae61814a0f418f97a3729ce39161162022-12-21T16:52:27ZengBMCInternational Journal of Retina and Vitreous2056-99202017-08-01311410.1186/s40942-017-0083-xGiant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastomaCamila V. Ventura0Audina M. Berrocal1Jennifer Thomson2Fiona J. Ehlies3Azeema Latiff4Timothy G. Murray5Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of MedicineDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of MedicineMurray Ocular Oncology and RetinaMurray Ocular Oncology and RetinaMurray Ocular Oncology and RetinaMurray Ocular Oncology and RetinaAbstract Background Retinoblastoma is considered the most common intraocular malignancy in childhood, comprising 4% of all pediatric cancers. Management of retinoblastoma has evolved over the past two decades and intra-ophthalmic artery chemotherapy has emerged as a new modality of globe-conserving treatment with excellent results. This treatment achieves effective tumor reduction by delivering localized chemotherapy, decreases enucleation rate, and minimizes systemic and local side effects. Case presentation We report the case of an 8-year-old girl with a late presentation of an advanced unilateral retinoblastoma associated to diffuse exudative retinal detachment in the right eye, classified as group E by the International Classification of Retinoblastoma. The initial therapeutic proposal for the patient was five sessions of intra-ophthalmic artery chemotherapy (IAC) associated to large spot diode laser therapy. After undergoing four sessions of IAC, the fundus exam revealed a giant retinal tear associated to a total retinal detachment in the affected eye. The IAC treatment was concluded and enucleation was considered the best treatment option at that moment, since IAC was unable to control the tumor’s activity and the patient’s eye presented with a complex rhegmatogenous retinal detachment (RRD). However, family left for a second opinion and never returned. Conclusions The usage of IAC for retinoblastoma management may lead to important local complications. Despite rare, RRD secondary to IAC may occur. We postulate that the giant tear observed in this case was caused by the rapid tumor necrosis using this route of treatment.http://link.springer.com/article/10.1186/s40942-017-0083-xRetinoblastomaIntra-arterial chemotherapyRhegmatogenous detachment |
| spellingShingle | Camila V. Ventura Audina M. Berrocal Jennifer Thomson Fiona J. Ehlies Azeema Latiff Timothy G. Murray Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma International Journal of Retina and Vitreous Retinoblastoma Intra-arterial chemotherapy Rhegmatogenous detachment |
| title | Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma |
| title_full | Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma |
| title_fullStr | Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma |
| title_full_unstemmed | Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma |
| title_short | Giant retinal tear after intra-arterial chemotherapy for advanced unilateral retinoblastoma |
| title_sort | giant retinal tear after intra arterial chemotherapy for advanced unilateral retinoblastoma |
| topic | Retinoblastoma Intra-arterial chemotherapy Rhegmatogenous detachment |
| url | http://link.springer.com/article/10.1186/s40942-017-0083-x |
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