METASTATIC RETINOBLASTOMA - RECENT PROGRESS OF INTEREST TO ORTHOPEDICSURGEONS

Retinoblastoma is the most common malignant intraocular neoplasm of ch ildhood. Distant metastases to bone and bone marrow occur. The authors report on a retinoblastoma patient with metastases to the extraaxial skeleton. Implications for the orthopaedic surgeon and alternative dia gnostic modalities are discussed. The case presented here exemplifies the potential role for the orthopaedic surgeon in making such a diagno sis in a child previously treated for retinoblastoma. Secondary nonocu lar malignant tumors should be considered in the differential diagnosi s of patients with a history of retinoblastoma who have a painful extr emity. Radiation treatment of the primary tumor increases the risk for nonocular secondary neoplasms, The structural alterations in the reti noblastoma gene in patients with osteosarcomas and the possible role o f the retinoblastoma gene in the origin of osteosarcomas are also disc ussed.