Evaluation of Retinoblastoma According to Histological Grading, TNM Staging and Age at Presentation

Abstract

Objective: To evaluate retinoblastoma, according to histological grades, TNM staging and age at presentation. Materials and Methods: This cross sectional study was conducted in Department of Pathology BMSI- JPMC Karachi from 1st January 2009 to 31st December 2013 during which a total of 80 cases of retinoblastoma were received. Out of which 68 were reviewed and morphological diagnosis was done on H&E staining. Histological grades and TNM staging were categorized. The data was analyzed by using SPSS version 22. Results: In 80 cases of retinoblastoma the mean age of patients was 3.64 years with 3-4 years (53.75%) of age being the commonest. Amongst 68 cases, well differentiated retinoblastoma were seen in 7.35%, moderately differentiated 11.76%, poorly differentiated 26.47% and undifferentiated 51.41% cases. Varied pattern of TNM staging were observed. Majority (60.29%) in stage IV followed by 19.11% in stage I and 10.29% each in TNM stage II and III. Regional lymph node metastasis was seen in 4/68 cases (5.88%) while 3/68 (4.41%) showed distant (CNS) metastasis. All these cases (7/7) were in TNM stage IV with majority showing grade 4 (75%) and grade 3 (25%) histology. Conclusion: Evaluation of retinoblastoma showed that commonest age group was 3-4 years. Majority of retinoblastoma cases were undifferentiated (G4) followed by poorly differentiated (G3). While in TNM staging system varied pattern was observed, majority were in stage IV followed by Stage I. Majority of lymph node and distant metastasis were seen in grade 4 histology and all of them were in TNM stage IV.