Metastatic patterns of retinoblastoma
C. J. MacKay, D. H. Abramson and R. M. Ellsworth
Of 23 cases of metastatic retinoblastoma treated between 1922 and 1979,
seven had metastases limited to the cranial vault and 13 had cranial
metastases plus distant metastases. Globe pathology showed invasion of the
optic nerve and/or the choroid in all but two patients, but was not
predictive of the metastatic pattern. Initial signs of metastases were
neurologic impairment and an orbital or body mass; first symptoms were
anorexia or weight loss, vomiting, and headache. Most cases occurred by 3
years of age. Death occurred within 5.8 months on the average, despite
therapy. Useful tests for determining the extent of disease were bone
marrow aspiration, lumbar puncture, skull films, EEG, and brain scan.
Computed tomographic scans of the head, bone scans, bone marrow aspiration,
automated blood chemistry analysis, and lumbar puncture with immediate
ethyl alcohol processing should prove to be useful to detect metastatic
disease.
