【摘要】 我们报告了1例疑似盲眼中自然消退型视网膜母细胞瘤病例。肿瘤稳定，无眼外扩散长达20a。其他症状包括：带状角膜病变，白瞳，晶状体脱位，视网膜肿块钙化和牵引型视网膜脱离。
【关键词】 视网膜母细胞瘤；钙化；牵引型视网膜脱离
Abstract
We illustrated a case of presumed spontaneously regressed retinoblastoma in a blind eye. The tumour remained stable, with no extraocular spreading, for 20 years. Associating signs included band keratopathy, leukocoria, dislocated lens, calcified retinal masses and tractional retinal detachment.
KEYWORDS: retinoblastoma; calcification; tractional retinal detachment
INTRODUCTION
Retinoblastoma is a malignant tumour of the developing retina. It is the commonest primary malignant intraocular tumour in children[1]. Spontaneous regression of retinoblastoma is well documented in the literature[2]. We illustrated the clinical features of a presumed spontaneously regressed retinoblastoma in this report. We believes this was the first report of tractional retinal detachment as a feature of spontaneously regressed retinoblastoma in the literature.
CASE REPORT
A 20yearold man presented to us with no vision in the right eye since childhood. He was seeking cosmotic treatment for leukocoria in this eye, which was first seen by an ophthalmologist at the age of 4 months. CT scan at that time revealed an intraocular mass with calcification. Retinoblastoma was suspected and enucleation advised. However, this was refused by the parents, and they defaulted further followup.
At presentation, ocular examination of the right eye showed a noperceptionoflight vision with band keratopathy (Figure 1A), absent red reflex and aphakia. The calcified lens was seen in the vitreous inferiorly just anterior to a densely calcified retinal mass at 6 Oclock (Figure 1B). Another calcified mass was seen along the superotemporal arcade with adjacent pigmentation (Figure 1C) and tractional retinal detachment resulted from extensive preretinal fibrosis involving the macula (Figure 1D). The left eye was completely normal (Figure 2).
Figure 1A: the right eye showing band keratopathy and poor dilatation of the pupil after instillation of phenylephrine and tropicamide eye drops; B: fundus view of the inferior retina showing a large calcified retinal mass short arrow and the calcified dislocated lens anterior to it in the vitreous long arrow; C: choroidal mass along the superotemporal arcade with adjacent pigmentation and fibrous tissue; D:extensive fibrosis of the macula with resultant tractional detachment of the retina（略）
CT scan of orbits and brain showed extensive intraocular calcification in the right eyes with no extraocular extension and no intracranial abnormalities noted (Figure 3). Fluorescein Fundus Angiography (FFA) showed rich vascularization of both masses with double circulation pattern (Figure 4).
Figure 2Fundus photo of the left eye showing a normal fundus（略）
Figure 3Axial CT scan of the orbits showing extensive chorioretinal calcification in the right eye (short arrow), and the calcified dislocated lens (long arrow)（略）
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