[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Clinical Sciences
July 1998

Clinicopathologic Features of Retinoblastoma After Primary Chemoreduction

Author Affiliations

From the Departments of Ophthalmology (Drs Bechrakis and Foerster) and Pathology (Dr Coupland), Klinikum Benjamin Franklin, Free University of Berlin; Department of Ophthalmology (Drs Bornfeld and Schueler), University of Essen, Essen, Germany; and the Department of Pediatric Oncology-Hematology, Virchow-Klinikum, Humboldt University (Dr Henze), Berlin, Germany.

Arch Ophthalmol. 1998;116(7):887-893. doi:10.1001/archopht.116.7.887

Background  Primary chemotherapy is a new treatment approach in retinoblastoma, aiming to avoid radiogenic adverse effects, such as second tumor–associated mortality, as observed following external beam irradiation.

Objective  To describe the clinical and histopathologic regression pattern after primary chemotherapy in retinoblastoma.

Methods  Five patients with sporadic bilateral retinoblastoma underwent planned enucleation of their functionally blind eye after 2, 3 (in 2 patients), 4, and 6 courses of primary chemotherapy with carboplatin, etoposide, cyclophosphamide, and vincristine. The eyes were examined histopathologically, using light microscopy and immunohistochemical analysis with proliferation markers.

Results  One patient had a type 1 (cottage cheese) regression and 4 patients had either a type 2 (fish flesh) or a type 3 (combined) regression pattern. Histopathologic examination revealed a complete tumor necrosis in 1 patient with type 1 regression after 3 courses of chemotherapy and in 1 patient with type 3 regression after 4 courses of chemotherapy. The remaining 3 patients with type 2 or type 3 regression had histologically still active proliferative tumor cells after 2, 3, and 6 courses of chemotherapy.

Conclusion  This article correlates histopathologically the clinically described efficacy of primary chemotherapy in the treatment of retinoblastoma, underlining, however, the necessity of careful observation and the use of ancillary treatment whenever there is no complete tumor regression.