Plaque brachytherapy in unresectable medulloepithelioma with anterior chamber seeding and review of literature

Abstract

Medulloepithelioma is a rare nonhereditary tumor seen most often in children, usually in the first decade. In this paper, we present a case of extensive unresectable medulloepithelioma with neovascular glaucoma and anterior chamber seeding, which was confirmed histopathologically by performing biopsy and successfully managed using plaque brachytherapy along with a review of literature on brachytherapy in medulloepithelioma. The unique features in our case are extensive tumor, with anterior chamber seeding and neovascular glaucoma which have been successfully managed with brachytherapy. Also, the placement of brachytherapy plaque over the corneal surface has not been described previously for managing extensive medulloepithelioma. So far, brachytherapy has been tried in only three cases with concomitant neovascular glaucoma, of which two cases required subsequent enucleation.