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May 1969

Transverse Ischemic Optic Nerve Necrosis in Neuroblastoma

Author Affiliations

Rotterdam, Netherlands
From the Central Pathological Laboratory, Academic Hospital Dijkzigt, Rotterdam, Netherlands.

Arch Ophthalmol. 1969;81(5):707-709. doi:10.1001/archopht.1969.00990010709019

NEUROBLASTOMAS or sympathicoblastomas arise from the primitive stages of ganglion cells of the peripheral nervous system. About 70% of these tumors are observed under the age of 4. The adrenal gland is the most common site of origin. The histological picture is typically one of highly cellular, homogenous masses of small regular cells, as large as, or slightly larger than, lymphocytes. Rosettes are present in a varying proportion of cases, ranging from 15% to 50%.1

Neuroblastomas frequently give rise to metastases. Many textbooks mention two clinical syndromes, viz, the Pepper type with hepatic secondaries and the Hutchison type with secondaries in the orbits, the skull, and the long bones. Mixed types occur, and a case presenting as a Pepper syndrome may subsequently develop the Hutchison picture. The incidence of the Pepper syndrome is significantly higher under the age of 6 months, the Hutchison variant usually appearing later. It has

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