Retinoblastoma other diagnostic studies

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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

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.[1]

Fluorescein angiography

Fluorescein angiography is a special type of x-ray procedure used to look at blood vessels inside the eye. A special orange dye called fluorescein is used to make blood vessels in the eye visible. The dye is injected into the arm and travels to the blood vessels in the eye. A series of pictures are then taken to:[1]

  • See how the cancer is responding to treatment
  • Predict how well a child will see after treatment

Bone marrow aspiration

Bone marrow aspiration is not done very often during diagnosis and staging of retinoblastoma. It 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

A lumbar puncture is not done very often during diagnosis and staging of retinoblastoma. It 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.[1]

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 reason to believe that the cancer has spread outside the eye.[1]

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. A germline mutation is an RB1 gene mutation that happened in a parent’s egg or sperm before conception (the joining of sperm and egg) and was passed on to the child. The genetic testing do not guide ocular therapy, but the presence of a germinal mutation can be helpful for screening for secondary cancers and family planning.[1]

References

  1. 1.0 1.1 1.2 1.3 1.4 Retinoblastoma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/retinoblastoma/diagnosis/?region=on Accessed on October 13 2015
  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.


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