Retinoblastoma presenting with orbital cellulitis.

Abstract

PURPOSE:

To study the effectiveness of pre-enucleation steroids in reducing inflammation in patients with retinoblastoma presenting as orbital cellulitis.

METHODS:

Medical records of consecutive retinoblastoma patients presenting at a single tertiary eye care center during a period of 3 years were retrospectively reviewed. For those who presented with orbital cellulitis, clinical, radiological, and histopathological variables were assessed. The effect of pre-enucleation steroids was noted in this group of patients.

RESULTS:

Of 260 retinoblastoma cases reviewed, 14 had retinoblastoma-associated cellulitis (5.39%). Of these 14 patients, 4 received neoadjuvant chemotherapy and were excluded from the series. Of the remaining 10 cases (mean age at presentation, 14.2 months; mean follow-up, 16.4 months), 9 presented with orbital cellulitis and were included in the study. Radiological imaging depicted intraocular tumors occupying 80% to 100% of the globe in each case. All patients underwent enucleation. Five children received pre-enucleation systemic steroids (mean, 5.4 days), which resulted in a prompt decrease in inflammation. Postenucleation chemotherapy was administered in 4 (6 cycles) and external beam radiation therapy in 1 patient with high-risk histopathological characteristics.

CONCLUSIONS:

Advanced necrotic retinoblastoma with anterior segment involvement may present as orbital cellulitis. Pre-enucleation systemic steroids can aid in the surgical management of these tumors.

• Authors: Jaydeep Walinjkar, S Krishnakumar, Lingam Gopal, Anita Ramesh, Vikas Khetan
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 17 Issue 3 Pg. 282-6 (Jun 2013) ISSN: 1528-3933 [Electronic] United States
• PMID: 23791410 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Topics

• Chemotherapy, Adjuvant
• Child, Preschool
• Combined Modality Therapy
• Diagnosis, Differential
• Eye Enucleation
• Female
• Follow-Up Studies
• Humans
• Infant
• Male
• Orbital Cellulitis (diagnosis, therapy)
• Radiotherapy, High-Energy
• Retinal Neoplasms (diagnosis, therapy)
• Retinoblastoma (diagnosis, therapy)