ĐẶC ĐIỂM MÔ BỆNH HỌC CỦA MẮT U NGUYÊN BÀO VÕNG MẠC ĐƯỢC ĐIỀU TRỊ CẮT BỎ NHÃN CẦU THỨ PHÁT GIAI ĐOẠN 2018-2022

Abstract

Objective: To describe the histopathological characteristics of retinoblastoma that secondary enucleation over a 5-year period (from January 2018 to December 2022) at the Vietnam National Eye Hospital. Subjects and Methods: A retrospective study was conducted on 82 medical records of patients diagnosed with retinoblastoma who underwent secondary enucleation from January 2018 to December 2022 at the Vietnam National Eye Hospital. Results: The number of secondary enucleation retinoblastoma increased gradually over the years (15 eyes in 2018, 9 eyes in 2019, 15 eyes in 2020, 21 eyes in 2021, and 22 eyes in 2022). The mean age of patients was 12.76 ± 13.81 months. The proportions of male and female patients were 48.8% and 51.2%, respectively, with no statistically significant difference. Among the 82 secondary enucleation retinoblastomas, there were 1 eyes extrorbital, 7 eyes group D, and the majority was 91.4% group E (75 eyes). The mean tumor size was 10.02 ± 2.753 mm. Due to chemoreduction, almost tumors ( 98,6%) that were in the group ≤ 15mm. High-risk histopathological features were observed in 47.5% of cases, including choroidal invasion (19.5%), anterior segment invasion (19.5%), and post-laminar optic nerve invasion (18.3%). However, no tumor cells were found at the cutting surface. Most tumors exhibited a mixed growth pattern, found in 57 out of 82 eyes (69.5%). There were 22% of difficulties determined by histopathological characteristics. There was no correlation between tumor size and the presence of high-risk histopathological features. In the group receiving ≤ 6 cycles of chemotherapy, the rate of high-risk histopathological features was lower at 42.4%, while in the group receiving > 6 cycles, this rate was significantly higher at 75% (a statistically significant difference). Conclusion: With the advancement of retinoblastoma treatment methods, combining chemotherapy with focal therapies, the number of secondary enucleations has increased. Although there have been changes in some histopathological characteristics, there is no evidence of unfavorable or extraocular invasion caused by delaying primary enucleation.