Unilateral Neoplasms Research Articles

Association of retinoblastoma with clinical and histopathological risk factors

A study was conducted to see the association of retinoblastoma with age, bilaterism, Tumor size, site, grades, involvement of anterior chamber, iris, ciliary body, choroid, sclera and optic nerve, and extraocular extension. This was a retrospective descriptive analytical study. The records of the Institute of Ophthalmology, King Edward Medical University/Mayo hospital, Lahore: Pakistan January 2006-Dec 2011 was analyzed. Five years biopsies (June 2006 to June 2012) of the retinoblastoma, from the Pathology department, was retrieved to see optic nerve involvement in all the retrieved specimens. The mean age was 3.54 ± 1.686 years. There were 15 cases of bilateral retinoblastoma and 37 cases with unilateral neoplasms. The age range of bilateral tumors was 2 - 6 years while the range in unilateral tumor was 1 - 10 years male to female ratio was 1:1.5. Among 52 cases, 37 (71.2%) patients were unilateral retinoblastoma and 15 (28.28%) patients were with bilateral disease. On radiological examination of patients suffering from retinoblastoma by B-Scan (Ultrasound), there were 33 (63.5%) cases with exophytic presentation while 18 (34.6%) cases showed endophytic morphology. On clinical examinations, 28 patients presented with proptosis of (it was the most common presenting sign in our patients, accounting for about 53.8% of cases), 20 cases presented with leucocoria eye with strabismus. 29/52 patients showed involvement with optic nerve, 17 were from 1 - 3 years age and 12 were from 4 - 6 years. Statistically there was no difference in the involvement of optic nerve, disc involvement and extra ocular extension with the age of patients (p = 0.217). There was also no statistical difference seen in age and gender for but a strong association was seen with patient’s presentation, symptoms and size of the tumors and anterior chamber, iris, ciliary body, choroid, sclera and optic nerve, and extra ocular extension. We concluded that a positive association was seen with tumor size and tumor extension (optic nerve, and extraocular extension). No Association was seen with age, gender and laterality of the tumors.

Pattern and Ocular Trend of Retinoblastoma and Treatment Option in Our Hospital

Abstract Objective: The study was conducted to see the pat-tern and ocular trend of Retinoblastoma and treatment option in our hospital. Study Design: Analytical Descriptive. Study Population: Patients with Retinoblastoma who visited the Institute of Ophthalmology from 2006 to 2011. Study Settings: Patients who came to Ophthalmology Department, Mayo Hospital, King Edward Medical University, Lahore. The study plan was approved by ethical committee of King Edward Medical University. Material and Methods: This was a retrospective des-criptive analytical study. The records of the Institute of Ophthalmology, King Edward Medical University / Mayo hospital, Lahore: Pakistan January 2006- Dec 2011 was analyzed. Five years biopsies (June 2006 to June 2012) of the retinoblastoma, from the Pathology department, ware retrieved to see optic nerve involve-ment in all the retrieved specimens. Results: There were 909 cases of Primary orbital les- ions and out of these 262/909 (29%) lesions were of primary orbital neoplasms. There were 65/262 (36%) cases of malignant neoplasms (62/65:95% case of Retinoblastoma and 3/65:5% cases of melanoma), the remaining 197/262 (64%) cases were benign tumors. There were 52 cases of Retinoblastoma with complete record and their blocks and data were retrieved from the previous record (2007 - 2011) of Ophthalmology and Pathology Department of Mayo Hospital/ King Edward Medical University, Lahore. There were 15 cases of bilateral retinoblastoma and 37 cases with unilateral neoplasms. The age range of bilateral tumors was 2 - 6 years while the range in unilateral tumor was 1 - 10 years. There 32 female and 20 males suffering from Retinoblastoma and male to female ratio was 1:1.5. Male were 38% and females were 61.5%. On clinical examinations, 28 (53.8%) patients presented with proptosis, 20 (38.5%)cases presented with leuco-coria eye was the second most common presenting sign, accounting for about 38.5% of cases), 3 cases (5.8%) with strabismus. Retinoblastoma caused secon-dary changes in the eye, including glaucoma and 1 case (1.9%) presented with sec glaucoma. The clinical findings in all the stages of retinoblastoma were nume-rous and varied. Surgical removal of the tumor was used as a standard management of very unfavorable retinoblastoma cases. Enucleation was performed when there was no chance of preserving useful vision in an eye. It was done in 21/52 (40.4%) cases. Exente-ration was also performed when extension of the tumor into the surrounding areas was considerable. It was performed in 31/52. Cryotherapy was used in bilateral involvement in second eye with small tumors located remote from the disc and macula. It was also used for recurrence after radiation therapy. 6/52 (11.5%) cases were treated with cryotherapy, 5 (9.6%) cases on right side and one case (1.9%) on left side. Conclusion: The most common pattern of retinoblas-toma was exophytic while the optic nerve and extra ocular involvement was one of the most prognostic factors for distance affecting the treatment. Patients suffering from optic nerve invasion and extra ocular extension or invasion of surrounding tissue with dis-tance metastasis were referred to Oncology Depart-ment.

Cerebellorubral degeneration after resection of cerebellar dentate nucleus neoplasms: evaluation with MR imaging.

The authors describe the magnetic resonance (MR) findings in seven patients who developed severe cerebellar symptoms and atrophy of the contralateral red nucleus following removal of unilateral neoplasms in the deep nuclei of the cerebellum. For most patients, pre- and postoperative spin-echo MR images were obtained with long repetition times (TRs) at 1.5 T. The long TR images obtained before surgery demonstrated unilateral masses involving the dentate nucleus. Long TR images obtained after surgical resection of the dentate nucleus showed increased signal intensity in all of seven contralateral red nuclei, three of seven ipsilateral superior cerebellar peduncles, and two of seven contralateral inferior olivary nuclei. Three other patients who underwent surgery for cerebellar neoplasms without resection of the dentate nuclei showed no postoperative brain stem changes on MR images. The authors speculate that the changes in the contralateral red nuclei are due to cerebellorubral degeneration (since well-described neural tracts interconnect the dentate nucleus and the contralateral red nucleus). Injury of the dentate nucleus may result in degeneration of distant neural connections.

Bilateral ovarian neoplasms and the risk of malignancy

Bilateral ovarian neoplasms are believed more likely to be malignant than are unilateral neoplasms. To our knowledge, this clinical tenet has not been evaluated or quantified. To test this hypothesis, we conducted a 10-year review of ovarian neoplasms found at the time of celiotomy at the Women's Hospital, Los Angeles County-University of Southern California Medical Center. Overall, women with bilateral neoplasms had a 2.6-fold increased risk of malignancy when compared with women who had unilateral neoplasms (95% confidence interval, 2.0 to 3.4; p

Bilateral ovarian neoplasms and the risk of malignancy

Bilateral ovarian neoplasms are believed more likely to be malignant than are unilateral neoplasms. To our knowledge, this clinical tenet has not been evaluated or quantified. To test this hypothesis, we conducted a 10-year review of ovarian neoplasms found at the time of celiotomy at the Women's Hospital, Los Angeles County-University of Southern California Medical Center. Overall, women with bilateral neoplasms had a 2.6-fold increased risk of malignancy when compared with women who had unilateral neoplasms (95% confidence interval, 2.0 to 3.4; p less than 0.001). The age-standardized relative risk was 1.8 (95% confidence interval 1.4 to 2.3). When standardized for the effect of menopausal status, the relative risk was 2.0 (95% confidence interval, 1.6 to 2.5). Bilaterality is associated with a doubling in the risk of cancer, a highly significant difference.

Renal Transplantation for Wilms Tumor: Report of 20 Cases

Renal transplantation as part of the treatment for Wilms tumor was done on 20 patients. In 80 per cent the neoplasms were bilateral. Transplantation is indicated in individuals whose renal function is severely impaired or absent because of the malignancy, treatment or both. Patients who received homografts less than a year after treatment of the tumors had a 47 per cent incidence of recurrence or metastases compared to a zero incidence of these problems in those whose transplants were delayed for longer periods. Survival for 2 years or more was obtained in 75 per cent of the recipients with unilateral neoplasms and in 38 per cent of the patients with bilateral tumors.