Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2022; 10(24): 8695-8702
Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8695
Retinoblastoma in an older child with secondary glaucoma as the first clinical presenting symptom: A case report
Ying Zhang, Li Tang
Ying Zhang, Li Tang, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zhang Y followed the patient and drafted the manuscript; Tang L was responsible for the revision and final approval of the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See https://creativecommons.org/Licenses/by-nc/4.0/.
Corresponding author: Li Tang, PhD, Doctor, Professor, Department of Ophthalmology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. tangli-1a@163.com
Received: February 23, 2022
Peer-review started: February 23, 2022
First decision: March 24, 2022
Revised: April 4, 2022
Accepted: July 20, 2022
Article in press: July 20, 2022
Published online: August 26, 2022
Abstract
BACKGROUND

Retinoblastoma (Rb) is primarily found in infants or young children. The most common primary presenting sign of Rb is leukocoria. Rb is very rare in children who are 10 years old or older. Timely and correct diagnosis as well as proper treatment are the key factors affecting the prognosis of Rb.

CASE SUMMARY

A 10-year-old girl with symptoms of vision loss, redness, swelling and pain in the right eye for 2 mo was admitted to our Department of Ophthalmology. The visual acuity of the right eye was graded as hand movement. The intraocular pressure of the eye was 46.9 mmHg. No substantial space-occupying lesion or characteristic calcified plaque was found in the eye. The patient underwent anterior chamber irrigation under general anesthesia on the same day of admission, and 2 mL of irrigation solution was saved for pathological examination. Histopathological examination of the anterior chamber fluid revealed cancer cells. A diagnosis of Rb with masquerade syndrome was made. The patient underwent enucleation followed by 6 rounds of systematic chemotherapy. A follow-up examination almost 9 years later found no relapse of Rb.

CONCLUSION

For older pediatric patients who have secondary glaucoma and uveitis symptoms without a clear cause of the disease and have no space-occupying lesion found by imaging examination, aqueous humor or vitreous humor examination is recommended for timely and correct diagnosis and appropriate treatment.

Keywords: Retinoblastoma, Secondary glaucoma, Uveitis, Masquerade syndrome, Older children, Case report

Core Tip: Retinoblastoma (Rb) is most commonly found in young pediatric patients, and is very rare in patients who are 10 years old or older. Here, we report a case of Rb in a 10-year-old girl with secondary glaucoma and other uveitis symptoms as clinical presenting signs. No obvious space-occupying lesions were found in the eye by imaging examination. However, anterior chamber fluid examination found cancer cells and was decisive in the diagnosis of Rb. This suggests the necessity of aqueous humor or vitreous humor examination in the diagnosis of Rb with atypical clinical symptoms.