Retinoblastoma

The malignant tumor of a mesh cover of an eye – a retinoblastoma, has a neuroectodermal origin and concerns to group of hereditary diseases. It is transferred to children from parents on autosomal dominantly type.

Today the number of cases of a retinoblastoma at children considerably increased. For comparison: on official medical statistics twenty years ago the retinoblastoma was diagnosed for children in 1 case on 30 thousand living newborns, today this indicator makes 1 case on 10-15 thousand.

The Retinoblastny tumor can be formed on any site of a retina. At an initial stage the new growth is shown by the broken eyeground clearness reflex. In the following stage of growth of a retinoblastoma flat muddy education with indistinct contours forms. Further development of a tumor depends on its type and the overall clinical picture of a disease.

Types of a retinoblastoma

As distribution in fabrics specialists subdivide 2 stages of a disease of a retinoblastoma:

1. Stage of endophytic growth (intraocular). At this stage of a disease the malignant tumor expands in an eyeglobe. Growth of a tumor is followed by increase in pressure in an eye, emergence of glaucoma, and sometimes and approach of a total blindness. The patient feels pain, dizziness, nausea, periodically there are emetic desires, in some cases persistent anorexia can be created.

2. Stage of exophytic growth (extraocular). At this stage of a disease malignant growth is not limited to eyeglobe space. Getting to intracranial area on an optic nerve, tumor cells extend on the central nervous system, metastasises take lymph nodes.

On one eye tumoral growth two above described types at the same time can be diagnosed at once.

There is also a division of a retinoblastoma on a disease etiology:

1. Hereditary retinoblastoma. The most widespread type of a disease (more than 70 percent of all cases). As a rule, the retinoblastoma at children is combined with other multiple inborn malformations – heart diseases, a cortical hyperostosis, a crevice of a soft palate etc. Extremely bystry development is characteristic of a hereditary retinoblastoma, the malignant tumor forms at the same time on two eyeglobes.

In most cases this type of a retinoblastoma comes to light at early age of the child (up to 30 months).

2. Sporadic retinoblastoma. Meets much less often. Forecasts concerning this type of a disease more favorable. At a sporadic retinoblastoma one eye is surprised, the new growth forms locally, i.e. one tumoral node (a unilateral tumor) is formed. The retinoblastoma of a sporadic form can be shown at later age.

Retinoblastoma reasons

Unfortunately, the reasons of emergence of a retinoblastoma still are thoroughly not established today (if this is not about hereditary cases of this disease). The unfavourable tendency to increase in number of diseases of a retinoblastoma obviously demonstrates negative impact of a modern ecological situation, poor quality of the food stuffs consumed by the majority causing genovariations at a pre-natal stage of fetation.

Retinoblastoma symptoms

The disease of rinoblastomy is followed by the following symptoms:

- reddening of eyes;

- pain syndrome;

- mydriatic pupils;

- partial or total loss of sight;

- sometimes squint;

- at later stage the leykokoriya – literally designates "a white eye" (a pupillary reflex not red as has to be, and white).

Diagnosis of a retinoblastoma

Diagnosing of a retinoblastoma is carried out in the conditions of a specialized hospital. Taking into account early age of patients retiblastomy all diagnostic actions and procedures are carried out under the general anesthesia. As a rule, physicians prefer not to take cytologic and histologic samples of sick fabrics as during an intake of material there is extremely high risk of tool transfer of cells of innidiation.

For diagnosis of a retinoblastoma the next obligatory researches are conducted:

- computer tomography of a brain, orbit of eyes, eyeglobes;

- ekhografiya;

- X-ray analysis;

- two-projective ultrasonic inspection of eyes;

- MRT (magnetic and resonant tomography).

As additional diagnostic methods can be used:

- marrow puncture;

- puncture of a spinal cord;

- radio isotope research of bones (osteostsintigrafiya).

Treatment of a retinoblastoma

Tactics of treatment of a retinoblastoma depends on the general clinical assessment of a condition of the patient, and also on a stage of formation of tumoral process.

Specialists subdivide retinoblastoma stages according to the following severity:

- 1 stage (tumoral education is limited to retina limits);

- The 2nd stage (tumoral education is limited to eyeglobe limits);

- 3rd stage (extraocular);

- The 4th stage (the metastasis is characterized by the remote distribution).

After definition of severity of a disease of a retinoblastoma the following medical events are used:

1. Surgery. Treats a last resort, it is applied at absolute loss of visual functions and utter impossibility of their recovery. As complex treatment chemical and beam therapies are appointed.

2. A cryolysis – therapy by low temperatures at a retinoblastoma of an easy stage of the front site of a retina.

3. Photocoagulation method. Use of laser beams renders good therapeutic effect at treatment of a retinoblastoma of an easy stage of the back site of a retina.

4. Thermotherapy (complex use of microwave therapy, infrared and ultrasonic radiation).