Retinoblastoma treatment progress _30414 by heku


									?Tumor, checking, cases, retina, cell

?Retinoblastoma treatment progress


Retinoblastoma in pediatric eye disease, is a most serious nature,
the worst kind of cancer, occurred in retinal nuclear layer family
genetic tendency is 5 years old can have monocular, binocular or both
suffer from the disease, and prone to intracranial metastasis, often
endanger the lives of children, so early detection, early diagnosis
and early treatment is to increase recovery rates, the key to
reducing mortality. We take this column to parents friends about
retinoblastoma treatment diagnosis of various common sense;
international advances in the treatment of ophthalmic laser treatment
of various advanced methods. Department of ophthalmology in

                                     – Children's Hospital eye tumor

                 Retinoblastoma (RB Retinoblastoma)

1. what the cause of retinoblastoma?
Retinoblastoma etiology and pathogenesis is not yet fully understood,
the current main that due to genetic mutations or hereditary genetic
Retinoblastoma can be divided into:
Differentiated: tumor cells around a column of cells of blood vessels
formation, in which the visible portion of the tumor cell necrosis
and the equanimity, calcium is called false Daisy-type (pseudosette).
The low degree of differentiation, high malignancy, but sensitive to
Differentiated: also known as Neuroepithelial type, square or
columnar cells, cells are arranged around a central cavity ring,
called Daisy-type (rosette). This type of differentiation, malignancy
is relatively low, but is not sensitive to radiation.
There are some cases of higher degree of differentiation, there is a
similar structure of photoreceptors, malignant degree minimum. Tumor
cell clusters like Lotus type (fleurette), also known as the
photoreceptor differentiated, recently said that this type for
retinal cell tumor (retinocytoma) as distinct from General

II. the retinoblastoma what are the symptoms?
According to tumor development process of manifestation and may
generally be divided into four phases.
1. the eye start growing: in normal growth, when the eye for children
old enough to not have impaired the Readme, so early in the disease
is generally not the parents. When the tumor proliferation process to
vitreous or close to the Crystal, pupillary reflex zones will appear
yellow, black, I dropped off of the cat's eye, often visually
impaired and Mydriasis, leukocoria or strabismus and parents find out.
2. the period of glaucoma gradually due to tumor growth in volume
increases, the contents of the eye, the increased intraocular
pressure, causing secondary glaucoma, the eye pain, headache, nausea,
vomiting, jealous, etc. Children's eye wall flexible chronic ocular
allows sphere with expansion, expansion of the eye, the formation of
a special "Bullseye" appearance, corneal scleral staphyloma, etc, and
congenital glaucoma, etc.
3. extraocular period:
(1) the earliest occurrence of the tumor cells along the optic nerve
to the brain tumor tissue and spread, due to the erosion of the
thicker the optic nerve, such as damaged optic nerve hole holes is
expanded osteoporosis, but the x-ray film size even if the optic hole
on the normal, except for the ball and intracranial metastasis.
(2) the tumor through for scleral enter the orbital, causing
exophthalmos; can also be caused by corneal staphyloma forward or
wear out the growth in the sphere of cornea and even highlight to
blepharophimosis, grow into large tumors.
4. systemic metastasis stage: transfer can occur at any stage, such
as occurred in the vicinity of the optic nerve of the nipple, even if
the tumour is small, with period prior to the transfer of the optic
nerve may be, but generally speaking the transfer to this edition is
the most obvious.

III. retinoblastoma which check needs to be done?
X-ray: visible to calcifications, or optic hole expansion. B: can be
divided into two substantive and cystic graphic, the former may be
early tumors, the latter on behalf of patients with advanced cancer.
CT: (1) in high-density masses: (2) in calcification, 30 ~ 90% of
cases with this discovery can be used as a diagnosis; (3) optic
thickened, optic hole expansion, spread to the brain tumor.
Fluorescein angiography: early stage cancer with period, namely,
fluorescence, venous phase and can seep into the tumor tissue,
dissipated by fluorescence in the diagnosis of late, a value.
Anterior chamber cytology: fluorescence microscopy, the tumor cells
are orange, positive rate high. Now as photochemical treatment before
clear diagnostic and therapeutic targets after treatment.
Urine tests of urine: vanillylmandelic acid (VMA) and a high oxalic
acid (HVA) 24-hour urinary excretion. When the urine VMA and HVA-
positive diagnosis, but when help feminine still cannot rule out
Lactate dehydrogenase (LDH) viability determination: when aqueous
serum LDH values above, both the ratio of the value is greater than
1.5, there are strong hints of retinoblastoma.
Other: for isotope scanning radiographic method, sclera, CEA, etc.
Rb development to third and fourth period is generally easy diagnosis,
but in the first and second time, the period in which the lens may
appear after the pupil area and white reflective or yellow-white
tissue called white pupil (leukoria).

4.   how the retinoblastoma treatment?
1.   operative treatment;
2.   chemical therapy;
3.   cryotherapy;
4.   photocoagulation therapy;
5.   radiation therapy;
6.   the Photodynamic therapy;
7.   immune therapy and gene therapy;

?Tumor, checking, cases, retina, cell

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