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==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Fluorescein angiography===
===Fluorescein angiography===
This imaging study can be used to differentiate retinoblastoma from other lesions.<ref name="Singh2016">{{cite journal|last1=Singh|first1=Arun D.|title=Retinoblastoma: Evaluation and Differential Diagnosis|volume=7|year=2016|pages=91–99|issn=1664-882X|doi=10.1159/000442228}}</ref>
This [[Imaging studies|imaging study]] can be used to differentiate [[retinoblastoma]] from other [[lesions]].<ref name="Singh2016">{{cite journal|last1=Singh|first1=Arun D.|title=Retinoblastoma: Evaluation and Differential Diagnosis|volume=7|year=2016|pages=91–99|issn=1664-882X|doi=10.1159/000442228}}</ref>
*Fluorescein angiography is particularly helpful in differentiating the tumor from the advanced form of Coats’s disease.
*[[Fluorescein angiography]] is particularly helpful in differentiating the [[tumor]] from the advanced form of [[Coats disease|Coats’s disease]].
*Imaging findings associated with the diagnosis of retinoblastoma include:
*Imaging findings associated with the [[diagnosis]] of [[retinoblastoma]] include:
**normal filling of enlarged dilated vessels entering a hyper- and hypofluorescent tumor mass
**normal filling of enlarged dilated [[vessels]] entering a hyper- and hypofluorescent [[tumor]] [[mass]]
**It stains and leaks depending on its size.
**It stains and leaks depending on its size.
===Bone marrow aspiration===
===Bone marrow aspiration===
[[Bone marrow aspiration]] is usually done only if the [[optic nerve]] contains cancer, which suggests that cancer may have spread outside the eye. It may also be done in patients who undergo enucleation and in whom the [[tumor]] is found at the cut section of the [[optic nerve]].<ref name="pmid7977596">{{cite journal| author=Mohney BG, Robertson DM| title=Ancillary testing for metastasis in patients with newly diagnosed retinoblastoma. | journal=Am J Ophthalmol | year= 1994 | volume= 118 | issue= 6 | pages= 707-11 | pmid=7977596 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7977596  }} </ref>
[[Bone marrow aspiration]] is usually done only if the [[optic nerve]] contains cancer, which suggests that cancer may have spread outside the eye. It may also be done in patients who undergo enucleation and in whom the [[tumor]] is found at the cut section of the [[optic nerve]].<ref name="pmid7977596">{{cite journal| author=Mohney BG, Robertson DM| title=Ancillary testing for metastasis in patients with newly diagnosed retinoblastoma. | journal=Am J Ophthalmol | year= 1994 | volume= 118 | issue= 6 | pages= 707-11 | pmid=7977596 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7977596  }} </ref>
===Lumbar puncture===
===Lumbar puncture===
[[Lumbar puncture]] may be done if the optic nerve or a large portion of the choroid contains cancer, which suggests that there is a risk that cancer has spread outside the eye.<ref name="CCS"> Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>  
[[Lumbar puncture]] may be done if the optic nerve or a large portion of the choroid contains cancer, which suggests that there is a risk that cancer has spread outside the eye.<ref name="CCS">Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>  
===Bone scan===
===Bone scan===
A bone scan is not used very often during the diagnosis and staging of retinoblastoma. It is usually only done if there is the reason to believe that cancer has spread outside the eye.<ref name="CCS"> Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>  
A bone scan is not used very often during the diagnosis and staging of retinoblastoma. It is usually only done if there is the reason to believe that cancer has spread outside the eye.<ref name="CCS">Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>  
===Genetic testing===
===Genetic testing===
Scientists have recently developed genetic tests to tell if there are changes to a [[gene]] ([[gene]] [[mutations]]). Gene testing involves looking at a person’s [[DNA]]. A test is done on blood or tissue to search for retinoblastoma 1 (''RB1'') gene mutations. Genetic testing may also be done in another family member, such as the child’s parents or siblings, especially if there is a family history of retinoblastoma or if the child is found to have a germline mutation. ''RB1'' gene mutation happens in a parent’s egg or [[sperm]] before conception and is passed on to the child. The genetic testing does not guide ocular therapy, but the presence of a germinal mutation can be helpful for the screening of secondary cancers and family planning.<ref name="CCS"> Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>
Scientists have recently developed genetic tests to tell if there are changes to a [[gene]] ([[gene]] [[mutations]]). Gene testing involves looking at a person’s [[DNA]]. A test is done on blood or tissue to search for retinoblastoma 1 (''RB1'') gene mutations. Genetic testing may also be done in another family member, such as the child’s parents or siblings, especially if there is a family history of retinoblastoma or if the child is found to have a germline mutation. ''RB1'' gene mutation happens in a parent’s egg or [[sperm]] before conception and is passed on to the child. The genetic testing does not guide ocular therapy, but the presence of a germinal mutation can be helpful for the screening of secondary cancers and family planning.<ref name="CCS">Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015</ref>


===Biopsy/FNAC===
===Biopsy/FNAC===
Unlike most other cancers, which need a biopsy to confirm the diagnosis, retinoblastoma can usually be diagnosed by an eye examination and imaging. A [[biopsy]] is not needed in many cases because of risk of orbital seeding and [[metastasis]].<ref name="CCS"> Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13, 2015</ref>
Unlike most other cancers, which need a biopsy to confirm the diagnosis, retinoblastoma can usually be diagnosed by an eye examination and imaging. A [[biopsy]] is not needed in many cases because of risk of orbital seeding and [[metastasis]].<ref name="CCS">Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13, 2015</ref>


==References==
==References==

Revision as of 19:28, 13 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Other diagnostic studies for retinoblastoma include fluorescein angiography, bone marrow aspiration, lumbar puncture, bone scan, and genetic testing.

Other Diagnostic Studies

Fluorescein angiography

This imaging study can be used to differentiate retinoblastoma from other lesions.[1]

Bone marrow aspiration

Bone marrow aspiration is usually done only if the optic nerve contains cancer, which suggests that cancer may have spread outside the eye. It may also be done in patients who undergo enucleation and in whom the tumor is found at the cut section of the optic nerve.[2]

Lumbar puncture

Lumbar puncture may be done if the optic nerve or a large portion of the choroid contains cancer, which suggests that there is a risk that cancer has spread outside the eye.[3]

Bone scan

A bone scan is not used very often during the diagnosis and staging of retinoblastoma. It is usually only done if there is the reason to believe that cancer has spread outside the eye.[3]

Genetic testing

Scientists have recently developed genetic tests to tell if there are changes to a gene (gene mutations). Gene testing involves looking at a person’s DNA. A test is done on blood or tissue to search for retinoblastoma 1 (RB1) gene mutations. Genetic testing may also be done in another family member, such as the child’s parents or siblings, especially if there is a family history of retinoblastoma or if the child is found to have a germline mutation. RB1 gene mutation happens in a parent’s egg or sperm before conception and is passed on to the child. The genetic testing does not guide ocular therapy, but the presence of a germinal mutation can be helpful for the screening of secondary cancers and family planning.[3]

Biopsy/FNAC

Unlike most other cancers, which need a biopsy to confirm the diagnosis, retinoblastoma can usually be diagnosed by an eye examination and imaging. A biopsy is not needed in many cases because of risk of orbital seeding and metastasis.[3]

References

  1. Singh, Arun D. (2016). "Retinoblastoma: Evaluation and Differential Diagnosis". 7: 91–99. doi:10.1159/000442228. ISSN 1664-882X.
  2. Mohney BG, Robertson DM (1994). "Ancillary testing for metastasis in patients with newly diagnosed retinoblastoma". Am J Ophthalmol. 118 (6): 707–11. PMID 7977596.
  3. 3.0 3.1 3.2 3.3 Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015


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