OCCURRENCE RATE OF HIGH RISK HISTOLOGICAL FEATURES IN PRIMARY ENUCLEATION SPECIMENS OF PEDIATRIC RETINOBLASTOMA PATIENTS: A LOCAL EXPERIENCE

Background: Retinoblastoma is the most common primary intraocular malignancy of childhood. The majority of cases are seen in children aged <5 years. The incidence of retinoblastoma is approximately 1 in 15,000 to 20,000 live births worldwide. Unfortunately, more than 3000 children die of retinoblastoma every year, with mortality rates being significantly higher in Asia and Africa. Objective was to determine frequency of high risk histological features in primary enucleated eye specimens having retinoblastoma for deciding therapeutic strategies. This cross-sectional study, conducted at the Histopathology department of Foundation University Medical College in Rawalpindi, aimed to determine the frequency of high-risk histological features in primary enucleated eye specimens with retinoblastoma to inform therapeutic strategies. Over a year, from September 25, 2019, to September 24, 2020. Methods: After approval from ethical review board, all patients fulfilling the inclusion criteria were enrolled in the study. All the demographic details of the patients including age, gender, duration since the diagnosis and family history of retinoblastoma were obtained. The specimens of retinoblastoma received form eye department were marked. Freshly cut 3-5 microns thick sections stained with Hematoxylin and Eosin (H & E) were examined microscopically by a team of two histopathologists. The presence or absence of high risk histological features was reported /recorded in the designed proforma. Results: A total of 150 patients were included in the study. The mean age of the patients was found to be 2.51 ± 1.30 years.  The gender distribution showed that most of the patients were males. The mean duration since diagnosis was 4.70 ± 2.81 months. Positive choroid invasion was found in 25 patients (16.7%) and optic nerve invasion was found in 77 patients (51.3%). Conclusion: The study showed that optic nerve invasion was found in significant number of patients and was more prevalent than choroid invasion in patients with retinoblastoma. This will help our clinicians to better guide our patients regarding the prognosis of the disease and deciding the treatment options for the patients.