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ORIGINAL ARTICLE
Year : 1983  |  Volume : 31  |  Issue : 4  |  Page : 421-423

Ocular tumours in children-a study of 75 cases


Departments of Ophthalmology and Pathology Rangaraya Medical College & Government General Hospital Kakinada, India

Correspondence Address:
S C Reddy
M. S. (Ophth), Asst. Prof. of Ophthalmology, Rangaraya Medical College & Govt. General Hospital, Kakinada (A.P.)
India
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Source of Support: None, Conflict of Interest: None


PMID: 6677602

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How to cite this article:
Reddy S C, Sarma C S, Ramana Rao V V, Banerjea S. Ocular tumours in children-a study of 75 cases. Indian J Ophthalmol 1983;31:421-3

How to cite this URL:
Reddy S C, Sarma C S, Ramana Rao V V, Banerjea S. Ocular tumours in children-a study of 75 cases. Indian J Ophthalmol [serial online] 1983 [cited 2020 Jun 1];31:421-3. Available from: http://www.ijo.in/text.asp?1983/31/4/421/27570

Table 1

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Table 1

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Among the reports available on ocular tumours in Indian literature, majority of them are on a particular group of tumours of either childhood or adult life ; few reports are on the analysis of tumours of all age groups and only one report' gives different types of ocular malignancies in children. Hence the authors felt that it was worthwhile to document their experience of different types of malignant and benign tumours of childhood, treated in the Department of Ophthalmology of the teaching Government General Hospital attached to Rangaraya Medical College, Kakinada, during the period 1961-82.


  Materials and methods Top


This study comprises of an analysis of 75 cases of histologically diagnosed ocular tumours in children, who presented with a swelling in the eye or whitish reflex in pupil­lary area associated with diminution of vision/ protrusion of eye ball. The excised growths or enucleated eyeballs were fixed, processed and stained by routine methods. All the slides were reviewed and special stains were done whereever required.


  Observations and discussion Top


Out of 75 cases studied, 36 were malignant tumours and 39 benign ; 40 were seen in boys and 35 in girls. The youngest child was aged 3 months and the oldest 12 years. Thirty three tumours were from retina, I from ciliary body, 28 from conjunctiva, 10 from eye lids and 3 were orbital tumours. All the tumours were unilateral except in two cases of retino­blastoma where the other eye was already enucleated and the diagnosis was confirmed histopathologically. There was not much significant difference in the involvement of right or left eye. Sex and age distribution of different types of histologically determined ocular tumours are shown in [Table - 1].

Retinoblastoma was the commonest mali­gnant tumour in this study, the others being diktyoma, squamous cell carcinoma of eye lid and malignant lymphoma of orbit, one case each.

In cases of retinoblastoma the average age of diagnosis was 32 years in the present study, and there were two infants aged 3 and 8 months. In the Western countries the average age of diagnosis in a large series has been re­ported to be 12 years. The age of youngest patient reported in Indian literature was 3 weeks 3 and in Western literature 4 days'. The commonest clinical presentation in these cases was yellowish white reflex in pupillary area (27 out of 33 cases). All stages of the tumour were observed. White reflex in pupillary area alone was seen in 16 cases and the same was associated with proptosis in 6 cases, with hazy cornea in 3 cases, with edema of lids and conjunctiva in 2 cases. In one case there was total hypopyon with associated edema of alids and conjunctiva. The material aspirated from anterior chamber showed malignant cells by cytological examination, thus indicat­ing that it was pseudo hypopyon of retinobl­stoma. In 5 cases cauliflower like fungat­ing growth was seen protruding from the eye ball.

Enucleation was done in 27 cases and ex­enteration in 3 cases. Palliative radiotherapy ' / endoxon chemotherapy was given in 2 cases of bilateral retinoblastoma and in 1 case of unilateral retinoblastoma with secondaries in scalp and chest wall. In one of the bilateral cases there was a mass protruding from right eye and the other eye was enucleated one year back. In the other case there was a whitish mass protruding into the vitreous with secondary retinal detachment in right eye and the other eye was enucleated one month back. In the above two cases preauri­cular lymphnode was enlarged and hard. Both the above cases were referred to our hospital by private practitioners.

Microscopically undifferentiated type of histological pattern with pseudo rosettes was seen in 20 cases and rosettes were seen in 10 cases. Areas of necrosis were seen in 12 cases, calcification in 5 cases and optic nerve invol­vement in 6 cases.

The followup of these cases was poor, however recurrence of the tumour in the orbit was seen in two cases after enucleation and in one case after exenteration. All the 3 cases were given radiotherapy followed by chemotherapy. The male child with seconda­ries in the scalp (frontal bone) and chest wall (ribs) survived for one year on endoxon therapy. Distant metastasis in pouch of Douglas was seen in a female child. She was given radiotherapy for local recurrence after enucleation in left eye. A large pelvic mass was observed after an uneventiful period of one year. The same was excised and proved to be a secondary from retinoblastoma. Her right eye and left orbit were normal.

In an analysis of 80 cases of ocular mali­gnancies in children, Dutta et al[1] found re tinoblastoma in 68 cases, rhabdomyosarcoma in 5, lymphosarcoma in 3, lacrimal gland tumours in 2, round cell sarcoma in 1, and Ewing's tumour in 1 case. Thirteen of retino­blastoma cases were bilateral and the tumour was seen in advanced stage (extraocular ex­tension or distant metastasis) in 61 cases.


  Summary Top


In an analysis of 75 cases of histologically diagnosed ocular tumours in children, 36 were found to be malignant and 39 benign; 33 were from retina, 1 from ciliary body, 28 from conjunctiva, 10 from eye lids and 3 were orbital tumours. The commonest malignant tumour was retinoblastoma and it was seen in all stages, with distant metastasis in two cases. Squamous cell carcinoma of eye lid and malignant lymphoma of orbit which are rare in children, were also seen in isolated cases. Nonspecific granuloma was the most frequent­ly observed benign tumour in the present study.[4]

 
  References Top

1.
Dutta, L.C., Barua, C.M. and Rajbarua, S.N, 1980. Abstract of paper presented in 39th All India Ophthalmic Conference, Manipal.  Back to cited text no. 1
    
2.
Ellsworth, R.M., 1969, Trans. Amer, J. Ophth­almol Soc. 67: 462.  Back to cited text no. 2
    
3.
Das, S.P., 1964, J. All India Ophth. Soc. 12: 128.  Back to cited text no. 3
    
4.
Steward, Smith and Arnald, 1956, Brit. J. Ophthalmol 40: 449.  Back to cited text no. 4
    



 
 
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