PMC8219460_01
Fundus photograph of the right eye after 16 sessions of systemic chemotherapy demonstrating significant response to treatment (a). In the left eye, fundus photograph shows multiple chorioretinal scars with scattered calcified vitreous seeds (b). Four months later, fundus pictures revealed a dome-shaped yellowish mass with overlying serous retinal detachment in the left eye (c). Two weeks later, there was significant lesion growth (d). Left eye B-scan ultrasonography reveals a huge underlying choroidal mass measuring 20 x 14 mm without any highly reflective foci (e). Photomicrograph of globe lesion, in lower magnification, shows massive choroidal invasion invading the whole thickness of the choroid which extended to the sclera (hematoxylin-eosin, x40) (f).
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At 4 years of age, 6 months after the last treatment, fundus examination showed a regressed tumor in both eyes without any signs of activity (Figures 1(a) and 1(b)). One month after the last IAC, surprisingly, we found a big inferonasal yellowish mass and adjacent retinal detachment with scant vitreous hemorrhage on it (Figure 1(c)). Under close observation, 2 weeks later, despite our decision for doing Ru106 plaque radiotherapy, indirect ophthalmoscopy showed rapidly growing ciliary body mass (Figure 1(d)). Ultrasound biomicroscopy showed a huge intraocular lesion with moderate internal reflectivity without any solid mass or remarkable calcification or highly reflective foci involving the choroid/ciliary body with dimensions of 20 x 14 mm (Figure 1(e)). Histopathology examination demonstrated extensive involvement of choroid, ciliary body, and angle with poorly differentiated retinoblastoma cells (Figure 1(f)).