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| ARTICLES |
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| Year : 1981 | Volume
: 29
| Issue : 2 | Page : 111-112 |
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Regressed retinoblastoma-a long term follow up
M Krishnan, DK Mehta, Rajini Kantha, PS Sandhu
Department of Ophthalmology, Lady Hardinge Medical College New Delhi, India
Correspondence Address:
M Krishnan
Department of Ophthalmology, Lady Hardinge Medical College New Delhi-110001
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 7327688 
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 |
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 | |  |
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 | | |
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 | | |
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 | | |
| 1. | Das, S.P., 1964, J. All India Ophthalmol. Soc., 12: 129.  |
| 2. | Dhir, S.P., Jain, I.S., and Das,. S.K., 1977, Ind. J. Ophthalmol., 24, IV, 35. |
| 3. | Parks, M.M. and Zimmerman, L.E., 1960, Clin Proc Child Hosp. D.C., 16: 77-84. |
| 4. | Duke Elder, S., 1967, System of Ophthalmology, Vol X, Henry Kimpton, London. P.P., 678-681, 688-692. |
| 5. | Dayal, Y., Angra, S.K.. Gahlot, D.K. Sharma, U., and sood, N.N., 1970, orient Arch. Ophthalmol., 8 : 158. |
| 6. | Jain. I,S. and Singh, K., 1968, J. All India Ophthalmol. Soc., 16 : 76. |
| 7. | Mehra, K.S. and Banerjee, C , 1965, Brit. J. Ophthalmol., 49 : 381. |
| 8. | Satyendram. O.M., Appalanarasiah, K. and Phatak, B K., 1965, orient. Arch., Ophthalmol.. 3 276. |
| 9. | Ells worth, R.M., 1969, Trane. Am. Ophthalmol. Soc; 67, 462:534. |
| 10. | Francois, J., Debie, S., Van Lenken, M., 1979, J. Paed Ophthalmol. and Strabismology., 16, 8, 85. |
| 11. | Kitchin, F.D., 1976, Tumors of the eye by Reese, A.B , third ed., pp., 127. |
| 12. | Sorsby, A., 1972, Br. Med. J;, 2 :580-513. |
| 13. | Ballantyne, A.J. and Michaelson, I.C., 1970, Text book of the fundus of the eye, 2nd ed., pp., 419, 427. |
| 14. | Grifflth, A.D. and Sorsby., 1144, Brit. J. Ophthalmol., 28 : 279 |
| 15. | Reese, A.B., 1976, Tumors of the eye, third ed., Harper and Row, New York., pp., 116. |
[Figure - 1], [Figure - 2]
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