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retinoblastoma
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RETINOBLASTOMA
EPIDEMIOLOGITumor primer, maligna, intraokular paling banyak pada (1:20,000) 2. Muncul sebelum usia 3 tahun3. Diturunakn (40%) or tidak diturunkan (60%)
4. Gen yang berperan(RPE 1) on 13q14
Leukocoria - 60% Strabismus - 20% Secondary glaucoma Anterior segment invasion Orbital inflammation Orbital invasionPresentasi Klinis dari retinoblastoma
Retinoblastoma Endofitik (awal)White flat lesionPlacoid lesion
Retinoblastoma Endofitik (Lanjut)Friable white massCottage cheese appearanceFine surface blood vesselsVitreous seedings
Retinoblastoma EksofitikMultiglobulated white mass withoverlying retinal detachmentMay be difficult to visualize through deep detachment
CT SCANCalcification Optic nerve involvement Orbital and CNS extension Pinealoblastoma
Terapi Retinoblastoma1. Small tumours Laser photocoagulation Transpupillary thermotherapy Cryotherapy2. Medium tumours Brachytherapy Chemotherapy External beam radiotherapy3. Large tumours Chemotherapy followed by local treatment Enucleation4. Extraocular extension External beam radiotherapy5. Metastatic disease Chemotherapy
HISTOPATOLOGIWell-differentiated with many Flexner-Wintersteiner rosettesPoorly differentiated
DIAGNOSIS BANDING LEUKORIACongenital cataract Unilateral or bilateral UnilateralInflammatory cycliticmembrane Persistent hyperplasticprimary vitreous Unilateral or bilateralCoats disease Unilateral UnilateralAdvanced retinopathy of prematurityPosterior pole toxocaragranuloma Always bilateral but may be asymmetrical