Retinoblastoma surgery: Difference between revisions
No edit summary |
No edit summary |
||
| Line 5: | Line 5: | ||
==Treatment options== | ==Treatment options== | ||
==Surgery== | |||
The surgery is called enucleation. During the surgery, an orbital implant is also put in to take the place of the eyeball. | |||
Eyes with large tumor burden (Group E eyes) and eyes that progress despite conservative treatments require enucleation. When an eye is enucleated for retinoblastoma, the goal is to remove as much optic nerve as possible to try ensure that the cut end of the nerve is free from tumor. The globe is sent for pathologic evaluation. Pathologic evaluation has clinical importance because it determines whether there are any pathologic risk factors for extraocular spread. | Eyes with large tumor burden (Group E eyes) and eyes that progress despite conservative treatments require enucleation. When an eye is enucleated for retinoblastoma, the goal is to remove as much optic nerve as possible to try ensure that the cut end of the nerve is free from tumor. The globe is sent for pathologic evaluation. Pathologic evaluation has clinical importance because it determines whether there are any pathologic risk factors for extraocular spread. | ||
Pathologic risk factors (PRF) that have been identified include: | Pathologic risk factors (PRF) that have been identified include: | ||
1. choroidal invasion | 1. choroidal invasion | ||
2. post-laminar invasion of the optic nerve | 2. post-laminar invasion of the optic nerve | ||
3. scleral invasion | 3. scleral invasion and | ||
4. involvement of the anterior chamber | |||
If PRFs are present, consideration should be given for adjuvant chemotherapy to decrease the risk of extraocular relapse. At the time of enucleation, the largest orbital implant is placed in order to encourage normal development of the pediatric orbit. Patients who have an eye enucleated will continue to be followed to ensure there is no evidence of tumor in the other eye. They will also need fitting for an ocular prosthesis. <ref>http://eyewiki.org/Retinoblastoma#Surgical_Treatment_of_Intraocular_Retinoblastoma</ref> | If PRFs are present, consideration should be given for adjuvant chemotherapy to decrease the risk of extraocular relapse. At the time of enucleation, the largest orbital implant is placed in order to encourage normal development of the pediatric orbit. Patients who have an eye enucleated will continue to be followed to ensure there is no evidence of tumor in the other eye. They will also need fitting for an ocular prosthesis. <ref>http://eyewiki.org/Retinoblastoma#Surgical_Treatment_of_Intraocular_Retinoblastoma</ref> | ||
Revision as of 17:47, 3 September 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
|
Retinoblastoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Retinoblastoma surgery On the Web |
|
American Roentgen Ray Society Images of Retinoblastoma surgery |
|
Risk calculators and risk factors for Retinoblastoma surgery |
Overview
Enucleation remains the definitive treatment of intraocular retinoblastoma, particularly in the majority of patients who present with unilateral disease.
Treatment options
Surgery
The surgery is called enucleation. During the surgery, an orbital implant is also put in to take the place of the eyeball. Eyes with large tumor burden (Group E eyes) and eyes that progress despite conservative treatments require enucleation. When an eye is enucleated for retinoblastoma, the goal is to remove as much optic nerve as possible to try ensure that the cut end of the nerve is free from tumor. The globe is sent for pathologic evaluation. Pathologic evaluation has clinical importance because it determines whether there are any pathologic risk factors for extraocular spread. Pathologic risk factors (PRF) that have been identified include: 1. choroidal invasion 2. post-laminar invasion of the optic nerve 3. scleral invasion and 4. involvement of the anterior chamber If PRFs are present, consideration should be given for adjuvant chemotherapy to decrease the risk of extraocular relapse. At the time of enucleation, the largest orbital implant is placed in order to encourage normal development of the pediatric orbit. Patients who have an eye enucleated will continue to be followed to ensure there is no evidence of tumor in the other eye. They will also need fitting for an ocular prosthesis. [1]
References