Dr. Bhandari Akshay Jawahirlal

1. E POSTER
A CASE OF ENDOPHYTIC
RETINOBLASTOMA

2. AUTHORS
1. Dr. Akshay Jawahirlal Bhandari (Assistant
Professor)
2. Dr. Shobhana Jorvekar (Assistant Professor)
3. Dr. Surekha Bangal (Professor)
4. Dr. Dipti Dilip Padghan

3. Introduction
• Retinoblastoma is the most common
intraocular malignancy in children.
• It arises from the neurosensory retina with
proliferation of neural cells, which have
failed to evolve normally.
• Retinoblastoma arises as a malignant
proliferation of the immature retinal neural
cells called retinoblasts.
• Incidence is slightly higher in males than
females.

4. Introduction
• It results either from sporadic or heritable
mutations in the retinoblastoma gene, RB-1
on long arm of chromosome 13.
• Heritable forms greatly elevated risk of
developing a second malignancy, commonly
oestrogenic sarcomas, and lung and breast
cancer.
• In few cases, there is bilateral involvement
although one eye is affected more
extensively & earlier than the other.

5. Case Report
• A 2 years old male child was brought to
Ophthalmology OPD by his parents for the
presence of white reflex in right eye since 1-2
months.
• Not associated with any other complaints. no
history of trauma or eye infection.
• Child was born full term and healthy.
Developmental milestones were adequate for
the age. No history of similar complaints in the
family.
• General & systemic examination of the patient
was normal.

6. Case Report
• Ocular positions were normal & ocular
movements in both eyes were full & free in all
directions of gaze.
• Pupillary reaction to light was absent & patient
was not following the light.
• On Ophthalmic examination in right eye, white
reflex was seen in pupillary region.
• Rest of the anterior segment examination was
within normal limit.

7. Case Report
• Ophthalmoscopic examination of right eye revealed
whitish cauliflower like growth obscuring the details
of the fundus.
• Anterior segment & fundus findings of the left eye
were within normal limit.
• CT scan brain and USG ‘B’ scan of right eye
revealed an echogenic mass on the nasal aspect of
posterior segment with multiple foci of calcification

8. White pupillary reflex in Right
eye

9. Case Report
• With proper consent & anesthetic fitness patient
was posted for right eye enucleation.
• Enucleation of the eye ball was done &
specimen was sent for histopathological
examination.
• On histopathological examination, microscopic
sections from eyeball showed tumour mass
composed of dense masses of uniform small
round cells.
• Individual cells showed hyperchromatic nuclei &
scanty cytoplasm. Areas of calcification &
necrosis were seen. Sections from optic nerve
were free of tumour.

10. Clinical diagnosis of retinoblastoma was
confirmed
Gross specimenEnucleated eye
ball
Tumour cells with
hyperchromatic
nuclei

11. Discussion
• Retinoblastoma arises as a malignant
proliferationofthe immature retinal neural cells
called retinoblasts i.e., derived from
photoreceptorprecursor cells, which have lost
both anti-oncogenic genes either by deletion or
point mutation.
• Clinically, the most common presenting feature is
white pupillary reflex (also called amaurotic cat’s
eye appearance). Other presenting signs are
strabismus & nystagmus.

12. Conclusion
Although retinoblastoma is a malignant
tumour, it can be successfully treated and
its spread can be prevented in many
cases if early & accurate diagnosis is
made & prompt treatment is given.