We read with great interest the recent article by Shields et al.1 The authors are to be commended for their interesting observations concerning prevention of intracranial neuroblastic malignancy(trilateral retinoblastoma) by means of chemoreduction for retinoblastoma.
As the authors stated in their article, it appears that the incidence of pinealoblastoma is declining, probably because of prevention of malignant transformation by means of chemotherapy. We made the same observation in the Dutch population.2 The cumulative incidence for pinealoblastoma in patients with hereditary retinoblastoma was 9.3% (95% confidence interval, 2.7%-15.9%). We saw 7 patients with pinealoblastoma whose retinoblastoma was diagnosed and treated between 1973 and 1992. The subsequent pinealoblastoma was diagnosed between 1977 and 1994; unfortunately, all these patients died. In the Netherlands, no pinealoblastoma has been diagnosed since 1994.
Moll AC, Imhof SM, Schouten-van Meeteren AYN, Boers M, van Leeuwen F, Hofman P. Chemoreduction for Retinoblastoma. Arch Ophthalmol. 2003;121(10):1513. doi:10.1001/archopht.121.10.1513-a