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Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging

PURPOSE: To illustrate the diagnosis and management of an atypical, cyst-like recurrence of retinoblastoma. OBSERVATIONS: A 4-month-old boy was diagnosed with Group B retinoblastoma in the right eye, consisting of a 10 x 9 × 3.6 mm retinal tumor temporal to the macula. He was treated with one sessio...

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Autores principales: Ashkenazy, Noy, Diaz, J. Daniel, Hansen, Eric D., Harbour, J. William, Correa, Zelia M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9385537/
https://www.ncbi.nlm.nih.gov/pubmed/35990798
http://dx.doi.org/10.1016/j.ajoc.2022.101678
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author Ashkenazy, Noy
Diaz, J. Daniel
Hansen, Eric D.
Harbour, J. William
Correa, Zelia M.
author_facet Ashkenazy, Noy
Diaz, J. Daniel
Hansen, Eric D.
Harbour, J. William
Correa, Zelia M.
author_sort Ashkenazy, Noy
collection PubMed
description PURPOSE: To illustrate the diagnosis and management of an atypical, cyst-like recurrence of retinoblastoma. OBSERVATIONS: A 4-month-old boy was diagnosed with Group B retinoblastoma in the right eye, consisting of a 10 x 9 × 3.6 mm retinal tumor temporal to the macula. He was treated with one session of intra-arterial ophthalmic artery chemotherapy using melphalan, followed by three sessions of diode laser transpupillary thermotherapy (TTT), after which complete tumor regression was achieved. 45 weeks after initial treatment, a cystic lesion was detected adjacent to superior margin of the regressed tumor scar. The differential diagnosis included pigment epithelial detachment, retinal gliosis, secondary retinoschisis, and local tumor recurrence. Multimodal imaging including OCT angiography confirmed the diagnosis of local recurrence manifesting as a vascularized cyst-like lesion. Two additional sessions of TTT achieved sustained tumor regression through 16 months of additional follow-up. CONCLUSIONS AND IMPORTANCE: Recurrence of retinoblastoma following chemotherapy typically manifests as enlargement of a previously regressed tumor, or seeding into the vitreous or subretinal space. An unusual cyst-like recurrence of retinoblastoma at the margin of a previously regressed tumor was diagnosed by multimodal imaging. Focal diode laser transpupillary thermotherapy was curative.
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spelling pubmed-93855372022-08-19 Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging Ashkenazy, Noy Diaz, J. Daniel Hansen, Eric D. Harbour, J. William Correa, Zelia M. Am J Ophthalmol Case Rep Case Report PURPOSE: To illustrate the diagnosis and management of an atypical, cyst-like recurrence of retinoblastoma. OBSERVATIONS: A 4-month-old boy was diagnosed with Group B retinoblastoma in the right eye, consisting of a 10 x 9 × 3.6 mm retinal tumor temporal to the macula. He was treated with one session of intra-arterial ophthalmic artery chemotherapy using melphalan, followed by three sessions of diode laser transpupillary thermotherapy (TTT), after which complete tumor regression was achieved. 45 weeks after initial treatment, a cystic lesion was detected adjacent to superior margin of the regressed tumor scar. The differential diagnosis included pigment epithelial detachment, retinal gliosis, secondary retinoschisis, and local tumor recurrence. Multimodal imaging including OCT angiography confirmed the diagnosis of local recurrence manifesting as a vascularized cyst-like lesion. Two additional sessions of TTT achieved sustained tumor regression through 16 months of additional follow-up. CONCLUSIONS AND IMPORTANCE: Recurrence of retinoblastoma following chemotherapy typically manifests as enlargement of a previously regressed tumor, or seeding into the vitreous or subretinal space. An unusual cyst-like recurrence of retinoblastoma at the margin of a previously regressed tumor was diagnosed by multimodal imaging. Focal diode laser transpupillary thermotherapy was curative. Elsevier 2022-08-08 /pmc/articles/PMC9385537/ /pubmed/35990798 http://dx.doi.org/10.1016/j.ajoc.2022.101678 Text en © 2022 Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Ashkenazy, Noy
Diaz, J. Daniel
Hansen, Eric D.
Harbour, J. William
Correa, Zelia M.
Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging
title Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging
title_full Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging
title_fullStr Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging
title_full_unstemmed Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging
title_short Cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging
title_sort cyst-like recurrence of retinoblastoma diagnosed by multimodal imaging
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9385537/
https://www.ncbi.nlm.nih.gov/pubmed/35990798
http://dx.doi.org/10.1016/j.ajoc.2022.101678
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