EXTRAOCULAR METASTASES OF RETINOBLASTOMA IN CHILDREN AT DR. KARIADI HOSPITAL
Ima Sonia,Yetty Movieta,Bambang Sudarmanto
Fk undip FK Undip FK Undip
Background : Retinoblastoma is the most common intraocular malignant tumor in children. Two-thirds are diagnosed before 2 years of age and 95% before 5 years. The incidence of metastatic retinoblastoma is 9-11% in developing countries. In delayed or untreated cases, extraocular metastases occur mainly through optic nerve. The aim of this study is to report the metastatic site and clinical manifestation of extraocular retinoblastoma.
Material : A descriptive analytic study of 43 patients with retinoblastoma was carried out from medical record in Dr. Kariadi Hospital Semarang between 2015-2017.
Results : There were 43 patients diagnosed with retinoblastoma from 2015-2017. Two-thirds of patient had unilateral retinoblastoma and the rest were bilateral. Fourteen children (35%) had metastases. Metastatic sites including brain 11 (78%), lung 2 (14%) and femur 1 (8%). The brain metastasis was detected through cranial MSCT scan with contrast. Metastases were detected at the time of diagnosis in 10 patients whereas in 4 patient, metastases were detected during chemotherapy. All patient with metastases died whether given chemotherapy or not. Clinical manifestations of extraocular spread were orbital mass with proptosis 12 (85%), headache 10 (70%), vomiting 8 (57%), anorexia 8 (57%), irritability 6 (42%), seizure 4 (28%). Enucleation was done in 10 patients (70%) who already had extensive retinoblastoma.
Conclusions : Brain is the most common metastatic site in retinoblastoma. Orbital mass with proptosis is the most common sign of brain metastases. Retinoblastoma fatality is still very high
Keywords: retinoblastoma extraocular metastases
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