Spontaneous Regression of Retinoblastoma; A Report of Two Cases

Abstract

Two cases of presumed spontaneous regression of retinoblastoma have been presented: one resulting in a useful eye, and one in a phthisical eye. Neuroblastomata are closely related to retinoblastomata, if not the same tumour in another location. Spontaneous regression has been noted in some of these cases, and evidence is accumulating that this is due to the change from an active, aggressive type of tumour, usually fatal, through a process of maturation into an adult neuroganglioma type of lesion. It may be that some similar process occurred in our first case, especially in the mass below the disc.

Case Details

Personal Characteristics

18-year-old male, had left eye removed for a tumour when he was 21 months old, patients father had one eye removed in childhood because of an intraocular tumour, died from carcinoma of the bladder

Clinical Characteristics

Raised whitish mass with denser areas of pure white material (apparently calcium) above the disc, and a pearly white round mass surrounded by an area of choroidal degeneration below the disc, two scotomata corresponding to these masses

Remission Characteristics

No visible change in the right fundus and vision is still 20/20 over the past six and a half years

Treatment & Mechanisms

Proposed Remission Mechanisms

Spontaneous regression due to the change from an active, aggressive type of tumour, usually fatal, through a process of maturation into an adult neuroganglioma type of lesion

Clinical Treatment

Left eye enucleated

Additional Notes

The patient had bilateral ocular tumours at 21 months of age. One eye was enucleated and a diagnosis of retinoblastoma made pathologically. The other eye was not touched or treated, but 24 years later exhibited two masses presenting the picture of spontaneous regression of retinoblastoma, or of successfully treated tumours; namely a white chalky appearance and surrounding pigmentary disturbances.