Skip to main content

The value of “en toto” globe submission in the assessment of high-risk retinoblastoma cases and staging

International Ophthalmology volume 38, pages 35–41 (2018)Cite this article

Abstract

Purpose

To evaluate the importance of “en toto” globe submission in the assessment of high-risk pathological findings in retinoblastoma cases, aiming at identifying the additional value from full globe examination of enucleated eyes (including the calottes).

Methods

Retrospective histopathological case series of eighty-one enucleated globes with the clinical diagnosis of retinoblastoma, histopathologically examined at King Khaled Eye Specialist Hospital (KKESH) between January 2010 and December 2013. We included retinoblastoma eyes with any type of invasion (more than pT1) in which the globe was submitted “en toto.” All cases were histopathologically classified according to the American Joint Cancer Classification (AJCC TNM classification, 2009 6th edition).

Results

81 enucleated globes were examined, out of which 30 globes were classified as high-risk cases (more than pT1). 8 cases had massive choroidal invasion in both the PO sections and calottes. 5 cases had focal choroidal invasion in both. One case has massive choroidal invasion in calottes with very superficial ON head invasion. Two cases were found to have focal choroidal invasion in the calottes with prelaminar ON invasion. In these three cases (10%), the presence of focal or massive choroidal invasion in the calottes has affected the classification.

Conclusions

This study consolidates the guidelines recommended in the consensus meeting: from the International Retinoblastoma Staging Working Group on the pathology guidelines for the examination and evaluation of prognostic risk factors in retinoblastoma eyes. Full globe submission and examination should be the routine accepted practice universally even in underdeveloped countries.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Becker LE, Hinton D (1983) Primitive neuroectodermal tumors nervous system. Hum Pathol 14:538–555

    CAS  Article  PubMed  Google Scholar 

  2. Honavar SG, Sing AD, Shields CL et al (2002) Post-enucleation adjuvant in high risk retinoblastoma. Arch Ophthalmol 12:923–931

    Article  Google Scholar 

  3. Hurwitz RL, Shields CL, Shields JA, Cheve´z-Barrios P, Hurwitz MY, Chintagumpala MM (2002) Retinoblastoma. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology, 4th edn. Lippincott William and Wilkins, Philadelphia, pp 825–846

    Google Scholar 

  4. Broaddus E, Topham A, Singh AD (2009) Incidence of retinoblastoma in the USA: 1975–2004. Br J Ophthalmol 93:21–23

    CAS  Article  PubMed  Google Scholar 

  5. Grossniklaus HE (2014) Retinoblastoma. Fifty years of progress. The LXXI Edward Jackson Memorial Lecture. Am J Ophthalmol 158(5):875–891. doi:10.1016/j.ajo.2014.07.025

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dunphy EB (1964) The story of retinoblastoma. The XX Edward Jackson Memorial Lecture. Am J Ophthalmol 58(4):539–552

    CAS  Article  PubMed  Google Scholar 

  7. Bechrakis NE, Bornfeld N, Schueler A, Coupland SE, Henze G, Foerster MH (1998) Clinicopathologic features of retinoblastoma after primary chemoreduction. Arch Ophthalmol 116(7):887–893

    CAS  Article  PubMed  Google Scholar 

  8. Wardrop J (2013) Observations on the fungus haematodes or soft cancer. George Ramsay and Co, Edinburgh, p 1809

    Google Scholar 

  9. Albert DM (1987) Historic review of retinoblastoma. Ophthalmology 94(6):654–662

    CAS  Article  PubMed  Google Scholar 

  10. Reese AB, Ellsworth RM (1963) The evaluation and current concept of retinoblastoma therapy. Trans Am Acad Ophthalmol Otolaryngol 67:164–172

    CAS  PubMed  Google Scholar 

  11. Murphree AL (2005) Intraocular retinoblastoma: the case for a new group classification. Ophthalmol Clin N Am. 8(1):41–53

    Google Scholar 

  12. Gallie BL, Ellsworth RM, Abramson DH, Phillips RA (1982) Retinoma: spontaneous regression of retinoblastoma or benign manifestation of the mutation? Br J Cancer 45(4):513–521

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  13. Bader JL, Meadows AT, Zimmerman LE et al (1982) Bilateral retinoblastoma with ectopic intracranial retinoblastoma: trilateral retinoblastoma. Cancer Genet Cytogenet 5(3):203–213

    CAS  Article  PubMed  Google Scholar 

  14. Brownstein S, de Chadarevian JP, Little JM (1984) Trilateral retinoblastoma. Report of two cases. Arch Ophthalmol 102(2):257–262

    CAS  Article  PubMed  Google Scholar 

  15. Friend SH, Bernards R, Rogelj S, Weinberg RA, Rapaport JM, Albert DM, Dryja TP (1986) A human DNA segment with properties of the gene that predisposes to retinoblastoma and osteosarcoma. Nature 323(6089):643–646

    CAS  Article  PubMed  Google Scholar 

  16. Sastre X, Chantada GL, Doz F, Wilson MW, de Davila MTG, Rodrı´guez-Galindo C, Chintagumpala M, Che´vez-Barrios P (2009) For the international retinoblastoma staging working group, proceedings of the consensus meetings from the international retinoblastoma staging working group on the pathology guidelines for the examination of enucleated eyes and evaluation of prognostic risk factors in retinoblastoma, Arch Pathol Lab Med, Vol. 133

  17. Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M (2002) Retinoblastoma chapter. AJCC cancer staging manual, vol 6. Springer, New York, pp 371–376. doi:10.1007/978-1-4757-3656-4

    Chapter  Google Scholar 

  18. McLean IW, Burnier M, Zimmerman L, Jakobiec F (1994) Tumors of the retina. In: McLean IW, Burnier MN, Zimmerman LE, Jakobiec FA (eds) Atlas of tumor pathology. Tumors of the eye and ocular adnexa. Armed Forced Institute of Pathology, Washington, DC, pp 100–113

    Google Scholar 

  19. Gupta R, Vemuganti GK, Reddy VAP, Honavar SG (2009) Histopathologic risk factors in retinoblastoma. Arch Pathol Lab Med 133:1210–1214

    PubMed  Google Scholar 

  20. Eagle RC Jr (2009) High-risk features and tumor differentiation in retinoblastoma, a retrospective histopathologic study. Arch Pathol Lab Med 133:1203–1209

    PubMed  Google Scholar 

  21. Karcioglu ZA, Al-Mesfer SA, Abboud E, Jabak MH, Mullaney PB (1997) Workup for metastatic retinoblastoma: a review of 261 patients. Ophthalmology 104(2):307–312

    CAS  Article  PubMed  Google Scholar 

  22. Balaguer J, Wilson MW, Billups CA, Mancini J, Haik BG, Qaddoumi I, Khoury JD, Rodriguez-Galindo C (2009) Predictive factors of invasion in eyes with retinoblastoma enucleated after eye salvage treatments. Pediatr Blood Cancer 52(3):351–356. doi:10.1002/pbc.21845

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chong EM, Coffee RE, Chintagumpala M, Hurwitz RL, Hurwitz MY, Che´vez-Barrios P (2006) Extensively necrotic retinoblastoma is associated with high-risk prognostic factors. Arch Pathol Lab Med 130:1669–1672

    PubMed  Google Scholar 

  24. Hungerford J (1993) Factors influencing metastasis in retinoblastoma. Br J Ophthalmol 77(9):541

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  25. Folberg R, Salomao D, Grossniklaus HE, Proia AD, Rao NA, Cameron JD (2003) Recommendations for the reporting of tissues removed as part of the surgical treatment of common malignancies of the eye and its adnexa. Am J Clin Pathol 119:179–184

    Article  Google Scholar 

Download references

Funding

This work was supported by the College of Medicine Research Center, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.

Author information

Affiliations

  1. Departments of Ophthalmology & Pathology, College of Medicine, King Saud University-Medical City, Riyadh, Saudi Arabia

    Hind Manaa Alkatan

  2. Ophthalmology Department, University of Tabuk, Tabuk, Saudi Arabia

    Hani ALBalawi

  3. Pathology and Laboratory Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

    Azza M. Y. Maktabi

Authors
  1. Hind Manaa Alkatan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hani ALBalawi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Azza M. Y. Maktabi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hind Manaa Alkatan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest related to their work.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Alkatan, H.M., ALBalawi, H. & Maktabi, A.M.Y. The value of “en toto” globe submission in the assessment of high-risk retinoblastoma cases and staging. Int Ophthalmol 38, 35–41 (2018). https://doi.org/10.1007/s10792-016-0410-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-016-0410-5

Keywords

  • Retinoblastoma
  • Histopathology
  • Tumor classification