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Ocul Oncol Pathol. 2017 Dec;4(1):33-37. doi: 10.1159/000477410. Epub 2017 Jul 6.

Quadruple Neoplasms following Radiation Therapy for Congenital Bilateral Retinoblastoma.

Author information

1
Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
2
Department of Opthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
3
Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
4
Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Abstract

Purpose:

The aim of this study was to describe a 34-year-old male with hereditary bilateral retinoblastoma treated with radiotherapy as a child who developed 4 distinct tumors within the radiation field.

Methods:

A 34-year-old male with bilateral retinoblastoma status postradiation therapy and recurrence requiring enucleation presented with left-eye visual acuity changes. Magnetic resonance imaging demonstrated a left orbital mass and a right parasellar complex lobulated mass (right sphenoid and right cavernous sinus). Two weeks later, the patient underwent excision of the orbital mass and biopsy of an upper-lid nodule. This was followed by craniotomy for removal of the complex mass.

Results:

Histology revealed 4 distinct tumors, including an undifferentiated pleomorphic sarcoma (left orbit), a radiation-induced meningioma (right sphenoid), a schwannoma (right cavernous sinus), and a basal-cell carcinoma (left lid).

Conclusion:

Although occurrence of a second neoplasm is a well-known outcome following radiation treatment in patients with hereditary retinoblastoma, the diagnosis of 4 additional neoplasms is rare. Pleomorphic sarcoma, radiation-induced meningioma, and schwannoma are uncommon tumors and not well represented in the literature describing irradiated retinoblastoma patients. Secondary malignancies are a leading cause of early death in retinoblastoma survivors, and long-term follow-up is crucial for patient care.

KEYWORDS:

Bilateral retinoblastoma; Postradiation neoplasm; Radiation-induced meningioma; Schwannoma; Undifferentiated pleomorphic sarcoma

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