|Year : 1982 | Volume
| Issue : 1 | Page : 7-9
Behaviour of eye tumours with special reference to retinoblastomas-a retrospective study
VK Srivastava1, NN Agarwal2, RV Sharma3
1 Department of Pathology and Bacteriology, S.N. Medical College Agra, India
2 Department of Ophthalmology, S.N. Medical College Agra, India
3 Department of Physiology, S.N. Medical College Agra, India
V K Srivastava
Department of Pathology and Bacteriology, S.N. Medical College Agra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Srivastava V K, Agarwal N N, Sharma R V. Behaviour of eye tumours with special reference to retinoblastomas-a retrospective study. Indian J Ophthalmol 1982;30:7-9
The frequency of eye tumours in developing countries like India and Africa, is noted different from those met in European countries. The extent and severity of these eye tumours is also found different. African school of workers , attributed these differences to differences in the environmental factors between these countries. This prompted us to study the problem of eye tumours in our countrymen. It interested us to examine if the extent and severity of these tumours were related to "tumour-pattern."
| Materials and methods|| |
The material comprised of tissue from 126 cases of orbito-ocular and adnexal tumours, registered in the surgical file. Thirty enucleated and ninety six biopsy specimens were examined histologically. Clinical details were obtained from biopsy requisition forms and hospital case notes.
| Observations|| |
The final microscopic diagnosis in all 123 cases are shown in [Table - 1].
It is derived from the table that retinoblastomas preponderated amongst intraocular tumours. The analyses of only these tumours will be considered.
The clinical findings are summarised in [Figure - 1]. The tumour preponderantly occurred in males below 5 years. No familial concentration of these tumours was noted in the present series.
In the group of 21 enucleated specimens examined, the tumour was characterised by greyish white baemorrhagic mass, filling the vitreous chamber partly or completely [Figure - 2].
Microscopically the tumour presented two basic pattern diffuse collection of cells (76%) and cell-rosettes (24%) [Figure - 3]. In the diffuse pattern, the tumour cells were diffusely scattered in a relatively scanty connective tissue troma and the optic nerve invasion was recorded in 10 (62.5 per cent) tumours [Figure - 4]. By contrast, no optic nerve invasion was observed in tumour showing rosette pattern. Ischaemic necrosis, and calcification were noteworthy in these tumours [Figure - 5].
| Discussion|| |
With 126 cases registered in the surgical file, during the years of this study 1950-70, malignant tumours of the eye and adnexa accounted for 1.06 per cent of all the body malignant tumours Comparable figures from other countries are as follows : Denmark  - 0.36% Mozambique -3.2% Uganda -33%. The survey of these figures indicated preponderance of these tumours in Indians over Europeans.
Considered individually, retinoblastomas formed the bulk of ophthalmic tumours. Melanomas, so consistently known to occur in Europeans were seldom seen ,. The heavy score of these tumours under 16 months of age in European infants, indicated a careful reporting behaviour of parents in their country, rather than behaviour of the tumour. Most of the Indian parents reports and consent to surgery when an obvious fungating tumour has developed in their children's' eye. There is need of motivating them to report cases early in hospital and ophthalmic clinics.
Histologically, the tumour showed two types of cellular patterns : diffuse cell type and rosette formation. In tumours showing diffuse cell pattern, the optic nerve was invariably infiltrated. By contrast, in the tumours showing true rosettes, the optic nerve was spared. This finding suggested that retinoblastoma with rosettes structure, have lesser invasive capability and as such are less malignant than diffuse-cell types. Further it seemed that the rosette formation depended much on the extent of diseases, because when the lesion was extensive, it manifested diffuse cell pattern and when it was limited within eye-ball, it appeared in rosette pattern. The extent of necrosis varied. Widespread necrosis may have killed the tumour cells and caused spontaneous arrest of growth.
| Summary|| |
The analyses of 126 cases of Orbito-ocular cancers treated between 1950 and 1970 are presented. The tumour incidence noted in the present series was 1.06 per cent of all malignancies, much higher than in European countries. It is interesting to observe that their microscopic features determined their clinical behaviour specially optic nerve invasion. Diffuse cell pattern caused more frequently optic nerve invasion than rosette-cell pattern.
| References|| |
Clemmenson, J. 1965. Aeta Path. Microbiol. Scand. Suppl. 2 : 174.
Prates, M.D. 1958. Brit. J. Cancer 12 : 177.
Templeton, A.C., 1967. Cancer 20 : 1639.
Iliff, C.E. 1950. Tumours of the head and neck. Baltimore, William Wilkins, P. 491, Ed. 2, 1950.
Mork, T. 1961. Acta Ophthal. 39 : 824.
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]
[Table - 1]