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Small Case Series
December 2010

Clinicopathologic Review of Enucleated Eyes After Intra-arterial Chemotherapy With Melphalan for Advanced Retinoblastoma

Author Affiliations

Author Affiliations: Bascom Palmer Eye Institute, Department of Ophthalmology (Drs Mutapcic Vajzovic, Murray, Schefler, and Dubovy and Ms Hess), and Department of Pediatric Hematology (Dr Fernandes), University of Miami Miller School of Medicine, Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital (Drs Aziz-Sultan and Quintero Wolfe), and Florida Lions Oculopathology Laboratory (Dr Dubovy), Miami.

Arch Ophthalmol. 2010;128(12):1619-1623. doi:10.1001/archophthalmol.2010.296

Retinoblastoma is a rare disease with only 250 to 300 cases diagnosed per year in the United States. Over the last 15 to 20 years, the long-term survival rates have been up to 99% in the developed world with aggressive treatment including systemic chemotherapy combined with focal laser therapy. Newer treatment techniques are focused on globe conservation while minimizing toxic systemic adverse effects such as myelosuppression, need for blood transfusions, infections, and increased incidence of secondary tumors.1 One of these newer treatment techniques includes intra-arterial chemotherapy infusion of melphalan. This supraselective intra-ophthalmic artery chemotherapeutic drug delivery has been shown to be successful by Yamane et al2 and Abramson et al3 in advanced intraocular retinoblastoma (Reese-Ellsworth group V) cases. Herein, we report the clinicopathologic finding of 3 eyes of 3 patients diagnosed with advanced retinoblastoma, Reese-Ellsworth group Vb, or International Classification of Retinoblastoma group D, treated with supraselective intra-ophthalmic artery infusion of melphalan at our institution by a technique previously described by Abramson et al.3 The patients underwent enucleation for evidence of tumor progression.