Page 147 - TD-3-4

Tumor Discovery Primarily enucleated RB patient’s analysis

Table 1. Demographic profile of patients (n=78) Table 2. Presentation of the patients
Characteristics Number of patients (n, %) Clinical feature a Number
Age Months Leukocoria 55 (70.5%)
Median 33 Red eye 16 (20.5%)
Mean 34.56±19.90 Squint 10 (12.8%)
Range 3–90 Proptosis 05 (6.4%)
Male median age 30 Painful blind eye 03 (3.8%)
Male mean age 35.90±20.95 Decreased vision 03 (3.8%)
Female median age 35 Phthisis bulbi 01 (1.3%)
Female mean age 32.91±19.68 Duration of the symptom Months
Presentation (months) Number Range of duration 0.5 – 24
0 – 12 06 (7.69%) Mean 5.89±4.30
13 – 24 24 (30.77%) Mean duration for males 5.68±3.56
>24 48 (61.54%) Mean duration for females 5.94±5.09
Most frequent presenting age 24 months P value 0.966
Gender IIRC underwent enucleation (n=78; eye=79)
Male 43 (55.1%) Group D 06 (7.7%)
Female 35 (44.9%) Group E 73 (93.6%)
Laterality of presentation (n=78) a A single child may present with multiple signs. One patient required
Unilateral 70 (89.7%) bilateral enucleation, initially presenting with Group E in one eye and
Group C in the other. After the first enucleation, the patient was lost to
Bilateral 08 (10.25%) follow-up and later returned with recurrence.
Enucleation (n=78, eye=79)
Right 36 (46.2%) patterns were the least common at 7.7% (n = 6). Poor
Left 41 (52.6%) differentiation (44.9%, n = 35) was the most prevalent
Both 01 (1.3%) tumor differentiation. Well-differentiated tumors were
Positive family history observed in approximately 26% (n = 20) of cases, followed
by moderately differentiated tumors in 24% (n = 19) of
Yes 02 (2.6%) cases (Figure 2). Undifferentiated tumors were the least
No 76 (97.4%) frequent, occurring in only 5% (n = 4; Table 3). Among
78 patients, 84.6% (n = 66) were HRF-positive, while 15.4%
ranged from 15 days to 14 months in males and 30 days (n = 12) had tumors confined to the retina. Tumor invasion
to 24 months in females. The most common presenting was more prevalent in the posterior segment than in the
symptom was leukocoria (70.5%, n = 55), followed by red anterior segment. In cases of anterior segment invasion,
eye (20.5%, n = 16) and squint (12.8%, n = 10; Table 2). the anterior chamber was the most commonly infiltrated
One patient (1.3%) presented with phthisis bulbi, an (19.2%, n = 15), followed by the ciliary body (16.7%, n = 13)
atypical presentation. and iris (15.4%, n = 12). Both the trabecular meshwork
and Schlemm’s canal were infiltrated in 11.5% (n = 9) of
Most cases of primary enucleation were classified as cases each. Regarding posterior segment involvement,
Group E RB (93.6%), with 8% as Group D RB (Table 2). massive choroidal invasion occurred in 41% (n = 32) of
Among the eight bilateral cases, six were classified as cases, which was higher than optic nerve invasion at 38.5%
Groups E and B, and two cases as Groups D and C. The (n = 30), and 26.9% (n = 21) of cases showed retrolaminar
distribution of stages was as follows: 58% (n = 45) in Stage invasion without optic nerve transection. Choroidal
I, 33% (n = 26) in Stage II, and 5% (n = 4) in Stage III. (focal) and optic nerve (pre-laminar and laminar) invasion
were observed in 20.6% (n = 16) of cases. Among cases
3.3. Histopathological features and HRFs
with scleral invasion (15.4%, n = 12), 10.2% (n = 8)
Most patients (36%, n = 28) exhibited both endophytic and showed inner-third invasion, while 5.1% (n = 4) had a
exophytic growth patterns, followed by exophytic growth full-thickness invasion. Beyond intraocular invasion,
patterns (30.8%, n = 24). Approximately 26% (n = 20) of extrascleral invasion was found in 6.4% (n = 5) of cases,
cases were endophytic tumors, while diffuse infiltrating and orbital invasion was identified in 3.8% (n = 3; Table 3).

Volume 3 Issue 4 (2024) 4 doi: 10.36922/td.4336