Rétinoblastome

J.-M. Zucker , L. Desjardins , D. Stoppa-Lyonnet , F. Doz
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Abstract

Retinoblastoma is a rare embryonic tumour in very early childhood. If diagnosed as soon as leucocoria and strabismus (the too frequently neglected first symptoms) appear in patients with a tumour limited to retina, the multidisciplinary team may successfully initiate conservative treatment. In developed countries, retinoblastoma has become a curable disease and in poorer regions, although severe extra-ocular cases remain very frequent, the prognosis has been dramatically improved by combined radiochemotherapeutic strategies. Nevertheless, in these countries, sequelae of previous treatment remain frequent: eye enucleation, radiation-induced facial deformities, uni or bilateral impaired vision, second cancer in hereditary cases. Conversely, as a result of the trend to apply new conservative approaches, the quality of life of cured children should be radically improved, even if treatment complications can occur, as well as genetic predisposition to second tumours in hereditary retinoblastomas. Owing to the currently well established indication of prenatal diagnosis in familial cases, and despite the limitations of genetic analysis, direct or indirect detection of allelic losses can be performed in an increasing number of familial cases, contributing to more suitable genetic information.

红细胞
视网膜母细胞瘤是一种罕见的儿童早期胚胎肿瘤。如果在局限于视网膜的肿瘤患者出现白斑和斜视(经常被忽视的首发症状)时就诊断出来,多学科团队可能会成功地开始保守治疗。在发达国家,视网膜母细胞瘤已成为一种可治愈的疾病,在较贫穷地区,尽管严重的眼外病例仍然非常频繁,但通过放化疗联合治疗策略,预后已显著改善。然而,在这些国家,以前治疗的后遗症仍然很常见:眼球摘除、辐射引起的面部畸形、单侧或双侧视力受损、遗传性病例中的第二次癌症。相反,由于采用新的保守方法的趋势,治愈儿童的生活质量应该得到根本改善,即使可能出现治疗并发症,以及遗传性视网膜母细胞瘤中第二肿瘤的遗传易感。由于目前在家族性病例中有很好的产前诊断指标,尽管遗传分析存在局限性,但在越来越多的家族性病例中可以直接或间接地检测等位基因损失,从而有助于获得更合适的遗传信息。
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