98th Annual Meeting DOG 2000

K 702

Extraocular tumor growth after intraocular biopsy of retinoblastoma

A. Sch├╝ler, H. Schilling, N. Bornfeld

A diffuse infiltrating retinoblastoma with seeding cells of the tumor may simulate a typical intraocular inflammation. An intraocular biopsy in these cases may increase the risk for extraocular tumor spread and consecutively reduce the prognosis of survival.

Patients: Between 1990 and 1999 three children with advanced or diffuse infiltrating retinoblastoma and a medical history of a transscleral biopsy were presented in our department. The age varied between 3 and 13 years. All cases showed a unilateral disease. Anterior chamber biopsy in two cases and fine needle aspiration biopsy (FNAB) in one case showed retinoblastoma cells. Enucleation was indicated in all cases due to the advanced disease. In one case histology showed tumor cells in the corneoscleral channel of the biopsy. Surgical exploration of the orbit in the case after FNAB showed a circumscribed extraocular tumor growth on the sclera. Extraocular tumor growth in histology was the indication for a systemic polychemotherapy in two cases. In the third case we performed an external beam radiotherapy of the affected orbit after enucleation. During the follow up (10 years, 12 and 15 months) we did not observe a local or systemic recurrence of the tumor.

Conclusion: The risk of extraocular tumor spread after intraocular biopsy of retionoblastoma seems to be high. We recommend additional local or systemic treatment after a biopsy in retinoblastoma. Before a transscleral biopsy in children a retinoblastoma must be excluded by a clinical examination and, if necessary, by MRI- or CT scans. A transscleral biopsy is strictly contraindicated in cases with a suspected retinoblastoma.

Universit├Ątsaugenklinik Essen, Hufelandstr. 55, D-45122 Essen, Germany