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Study shows poor distinction between diffuse infiltrating retinoblastoma, other pathologies
Ophthalmology. 2008;115(12):2253-2258.
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Diffuse infiltrating retinoblastoma may mimic ocular diseases such as uveitis, unexplained hyphema or keratic precipitates, delaying accurate diagnosis and timely treatment.
"According to a recognized ophthalmic pathology textbook, diffuse infiltrating retinoblastoma is the least common growth pattern and often the most difficult to recognize clinically," the study authors said.
The retrospective case series included 34 eyes of 32 patients identified as having diffuse infiltrating retinoblastoma.
Histopathology showed retinoblastoma with poorly differentiated tumors (85%) and necrosis (88%). Clinical examination also showed tumor seeding into the vitreous (91%), subretinal space (59%) and vitreous hemorrhage (24%). Ultrasonography showed a lack of intraocular calcification in seven eyes (21%).
Modern imaging techniques can help clinicians discern retinoblastoma from other pathologies, the authors said.
"Any child with signs of uveitis, hyphema, hypopyon, vitreous hemorrhage or retinal detachment should be evaluated for retinoblastoma," they said. "Even if ocular imaging is negative for calcification, fundus evaluation by experienced examiners should be preformed, and interventional procedures should be avoided until the diagnosis of retinoblastoma is clearly excluded."