SUCCESSFUL TREATMENT OF A LATE CNS RECURR ENT RETINOBLASTOMA

Background. - Outcome of patients with retinoblastoma is strongly rela ted to the extent of the disease at diagnosis. Thus, prognosis of extr a-ocular retinoblastoma is poor and metastases to central nervous syst em are usually fatal. Case report. - An 8-year-old child presented wit h a late recurrence of bilateral retinoblastoma. Initial treatment had associated enuclation of the left eye and radiation therapy on the ri ght. At time of tumour recurrence, clinical examination showed cervica l lymph nodes. There was a large frontal metastasis on the CT scan and bone marrow examination showed a minimal involvement by malignant cel ls. The patient achieved complete remission with high dose etoposide a nd carboplatin; he subsequently underwent massive chemotherapy followe d by bone marrow rescue, and received additional radiation therapy on the frontal and cervical areas. He is well, five rears after relapse. Conclusion. - This case highlights efficacy of chemotherapy in advance d retinoblastomas. Intensive chemotherapy is a promising and potential ly curative approach in the management of advanced or metastatic retin oblastomas.