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Invited Commentary
December 2016

Detection of Retinoblastoma at Risk for Metastasis Using Clinical and Histopathologic Features and Now mRNA

Author Affiliations
  • 1The Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
  • 2Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
  • 3The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
JAMA Ophthalmol. 2016;134(12):1380-1381. doi:10.1001/jamaophthalmol.2016.2994

Although retinoblastoma (RB) is one of the most curable pediatric malignant abnormalities, death owing to metastatic disease is a real risk to many of the 8000 children who develop RB worldwide each year.15 Pathologic examination of the enucleation specimen currently guides need for adjuvant therapy. Most retinoblastoma experts agree that risk factors for metastasis include “massive” choroidal invasion over 3 mm in any dimension, postlamina cribrosa invasion into the optic nerve, and any combination of any degree of uveal, optic nerve, anterior segment, or scleral invasion. In general, retinoblastoma without high-risk histopathologic features rarely demonstrates metastatic disease, whereas those with high-risk features show a moderate propensity for metastatic events.

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