Bilateral retinoblastoma: a case report on

service
Health with limited facilities

Asna Tuppang, Marshalla Agnes, Junaidi

Wamena General Hospital
Background:

Retinoblastoma is a primary malignant

intraocular neoplasm originating from
immature retinal cells (retinoblasts) in
retinal development.
 Case Report
6 month before
4 month before
admission admission
admission
• the right eye • the right eye
• bump in his started to started to
right eye protrude protrude
• bump in his and got and got
right eye bigger as a bigger as a Right Eye Left Eye
• a white dot ping pong ping pong
appeared in ball and ball and
the middle bleeds easily bleeds easily
of the eye • Lymphadeno • Lymphadeno
• Painful pathy pathy
multiple multiple
• Blind • blind
• Weight lost
Discussion

 The pathogenesis of retinoblastoma is caused by mutations in the RB1 gene

located on chromosome 13q14. This disease can be heritable or non-
heritable.
 The most common clinical presentation of retinoblastoma is leukocoria
followed by strabismus. leukocoria seen in 22.6% to 97.9% of retinoblastoma
patients, whereas 5.6% to 26% of patients showed symptoms of strabismus.
 To establish a definite diagnosis of retinoblastoma, it is necessary to carry out
additional investigations. Based on the literature, imaging modalities that can
be used include ultrasonography, CT-scan, MRI and biopsy.
 The preferred therapeutic management is multimodal therapy with a
combination of high-dose initial chemotherapy, surgery (orbital
enucleation/exenteration), radiotherapy and continued chemotherapy as
much as 12 cycles.
Conclusion

 Retinoblastoma should be considered as an intraocular tumors especially in

children until proven otherwise.
 Specifically in areas with limited facilities, it is very important to be able to
detect early signs of retinoblastoma and avoid development of disease to
worse stage (extraocular retinoblastoma).
 In particular, in areas with limited health facilities, it is very important to
increase the awareness of the general public and health workers in
recognizing early signs and symptoms of retinoblastoma, in addition it is also
necessary to provide equitable health facilities to establish the diagnosis and
treatment of this disease.