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Year : 1981  |  Volume : 29  |  Issue : 2  |  Page : 111-112

Regressed retinoblastoma-a long term follow up

Department of Ophthalmology, Lady Hardinge Medical College New Delhi, India

Correspondence Address:
M Krishnan
Department of Ophthalmology, Lady Hardinge Medical College New Delhi-110001
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Source of Support: None, Conflict of Interest: None

PMID: 7327688

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How to cite this article:
Krishnan M, Mehta D K, Kantha R, Sandhu P S. Regressed retinoblastoma-a long term follow up. Indian J Ophthalmol 1981;29:111-2

How to cite this URL:
Krishnan M, Mehta D K, Kantha R, Sandhu P S. Regressed retinoblastoma-a long term follow up. Indian J Ophthalmol [serial online] 1981 [cited 2023 Nov 30];29:111-2. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1981/29/2/111/30976

Well authenticated Cases of Spontaneous regression of retinoblastoma have been repor­ted[1],[2],[3]. At least 21 cases with long follow up have been recorded wherein regression has been apparently complete[4]. Usually regression of retinoblastoma leads to a phthisical eye.[5],[6],[7],[3],[8] Authors report a case of sponta­neously regressed retinoblastoma in a child with retention of Visual acuity of 6/5, after a long follow up period of 18 years, with out any evidence of genetic transmission.

  Case report Top

A 3 year old male child, R.S,, presented with bilateral retinoblastoma in August 1962. The right eye presented as cat'samurotic eye with an advanced lesion. This was enucleated and histopathology proved the diagnosis [Figure - 1],[Figure - 2]. Fundus Examination of the left eye showed a solitary, avascular growth of about 2 disc diameter, with well defined margins in the nasal mid periphery. There was no radio­logical evidence of metastasis, as the X-ray chest, Skull and pelvis with upper half of femora, was found to be normal. Radon seed implantation in the sclera, adjacent to the tumour though advised, could not be carried out, inspite of the real need, for want of medical facilities in India in 1962.

The patient has been followed up for a period of 18 years. The lesion has remained the same size without any progression, but the margins have become irregular with pig­mentation at 1 & 8 O' Clock positions [Figure 3]. The visual acuity of the patient is 6/5 and we must add that he has completed B. A. in Political Sciences. The patient is the only child of his parents who are normal and healthy. There is no evidence of retinoblastoma or an unexplained phthisical eye in the close relatives.

  Discussion Top

As a general rule bilateral cases are heredi­tary in nature and is due to germinal muta­tion.[9],[10][11],[12]. Tumours arising as a germinal mutation are transmitted as an irregular dominant trait with incomplete penetrance and majority of these cases tend to be bilate­ral[13],[14]. Howeverin this case, no evidence or a genetic transmission was found.

Spontaneous regression has been attributed to the tumour outgrowing its blood supply and stimulation of host resistant antigens[15]. Three regression patterns have been recogni­sed. (a) Cottage cheese type (b) avascular homogenous mass (c) Combination of `a' and 'b' This case belonged to the `b' category. Usually regression of retinoblastoma leads to a phthisical eye. Contrary to this, the patient had a visual acuity of 6/5 after a period of 18 years.

  Summary Top

A rare case of spontaneous regression of retinoblastoma with normal vision after 18 years of follow up, with no evidence of genetic influence is reported.

  References Top

Das, S.P., 1964, J. All India Ophthalmol. Soc., 12: 129.  Back to cited text no. 1
Dhir, S.P., Jain, I.S., and Das,. S.K., 1977, Ind. J. Ophthalmol., 24, IV, 35.  Back to cited text no. 2
Parks, M.M. and Zimmerman, L.E., 1960, Clin Proc Child Hosp. D.C., 16: 77-84.  Back to cited text no. 3
Duke Elder, S., 1967, System of Ophthalmo­logy, Vol X, Henry Kimpton, London. P.P., 678-681, 688-692.  Back to cited text no. 4
Dayal, Y., Angra, S.K.. Gahlot, D.K. Sharma, U., and sood, N.N., 1970, orient Arch. Ophthalmol., 8 : 158.  Back to cited text no. 5
Jain. I,S. and Singh, K., 1968, J. All India Ophthalmol. Soc., 16 : 76.  Back to cited text no. 6
Mehra, K.S. and Banerjee, C , 1965, Brit. J. Ophthalmol., 49 : 381.  Back to cited text no. 7
Satyendram. O.M., Appalanarasiah, K. and Phatak, B K., 1965, orient. Arch., Ophthalmol.. 3 276.  Back to cited text no. 8
Ells worth, R.M., 1969, Trane. Am. Ophthalmol. Soc; 67, 462:534.  Back to cited text no. 9
Francois, J., Debie, S., Van Lenken, M., 1979, J. Paed Ophthalmol. and Strabismology., 16, 8, 85.  Back to cited text no. 10
Kitchin, F.D., 1976, Tumors of the eye by Reese, A.B , third ed., pp., 127.  Back to cited text no. 11
Sorsby, A., 1972, Br. Med. J;, 2 :580-513.  Back to cited text no. 12
Ballantyne, A.J. and Michaelson, I.C., 1970, Text book of the fundus of the eye, 2nd ed., pp., 419, 427.  Back to cited text no. 13
Grifflth, A.D. and Sorsby., 1144, Brit. J. Ophthalmol., 28 : 279  Back to cited text no. 14
Reese, A.B., 1976, Tumors of the eye, third ed., Harper and Row, New York., pp., 116.  Back to cited text no. 15


  [Figure - 1], [Figure - 2]


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