Pathology of retinal cancer

2021-02-02 12:00 AM

If the tumour is large and life-threatening, surgery to remove the eyeball with long nerve vision is needed. The prognosis is good if the tumour has not grown out through the optic nerve.

Retinal cancer is a rare but common malignant tumour in children's eyes. It is caused by a genetic mutation, has an inherited factor and can lead to death if not diagnosed and treated early.

Diagnose

The most common sign of corneal cancer is white pupils. In the dark, dilated pupils give the patient a blue light (which looks like a blind cat's eye), a sign that often helps the patient's parents detect the disease. Other signs that may be found in retinal cancer, such as squinting, uveitis, obituarists, anterior purulent, vitreous haemorrhage, or glaucoma often present a problem distinguishing from other eye diseases.

Figure - White pupil

Fundoscopy is an important test to diagnose a disease. Lesions in the retina have different manifestations depending on the direction of tumor development. The small tumor (also localized between the inner and outer diaphragm) is gray in color. Endophytic tumors, that are, penetrating through the inner diaphragm of the retina, are white or yellow in color, many plots, on the tumor surface may have small blood vessels (Figure 2.2). Cleaved tumor cells and fragments enter the vitreous fluid causing signs such as intraocular inflammation or anterior chamber entry to produce a sign of anterior purulent fusion. An extrovert (exophytic) tumor, which is a tumor that develops below the retina is often yellow-white and retinal blood vessels above the tumor are dilated and zigzagged, tumor growth may be accompanied by increased secretion. under the retina looks like Coats.

Diagnostic imaging methods help confirm the diagnosis. Ultrasound examination and tomography can clearly see the size and location of the tumour or see calcification images in the tumor (characteristic sign of retinal cancer), in addition can determine the development of the tumor is out of the eyeball or into the intracranial.

Figure - Retinal tumour

Differential diagnosis

It is necessary to distinguish retinal cancer from some other children's eye diseases also with white pupil signs:

Coats Disease: Vascular changes (vasodilation) in the periphery of the retina, abundant subretinal fluid, no calcium, usually in the eyes, no genetic factors.

Premature retinopathy: seen in premature babies with low birth weight and receiving supplemental oxygen therapy. The coronary proliferation and retinal detachment make pupils white.

Primitive vitreous hyperplasia: angiogenesis and glia in vitreous, small eyeballs, cataracts, elongated fold folds (visible with dilated pupils), glaucoma, detachment cornea.

Congenital uveitis: often with pupillary adhesions, may be accompanied by cataracts.

Congenital cataract: cloudy immediately behind the iris, may be accompanied by strabismus, shaking of the eyeball.

Toxocara nematode: showing a granuloma in the retina or intraocular inflammation, and stretching fibrous bands in the vitreous can cause retinal detachment.

Treatment

If the tumor is large and life-threatening, surgery to remove the eyeball with long nerve vision is needed. The prognosis is good if the tumor has not grown out through the optic nerve.

If the tumor is still small, it can be conservative treatment with one of the following methods:

Frozen: indicated for small and anterior tumors.

Xenon or laser arc coagulation (argon and krypton): indicated for small and posterior tumors.

Radiation: remote irradiation (only for large and posterior tumours) or radioactive isotope plate (commonly used cobalt-60, iodine-125, ruthenium-106, and iridium-192) fixed on sclera at tumor location (indicated for medium size tumors).

Chemical therapy: used for cases that have metastasized or have many risks of systemic metastasis. Commonly used drugs are vincristine sulfate (Oncovin), doxorubicin (Adriamycin), cyclophosphamide (Cytoxan), carboplatin (Para platin).