【摘要】 目的：回顾发展中国家在治疗视网膜母细胞瘤中的挑战。 方法：回顾1998-01/2002-12，埃努古的尼日利亚大学教学医院和Ebrans临床中心的视网膜母细胞瘤患者的临床及组织病理学资料。 结果：总共34例通过组织学被确诊为视网膜母细胞瘤患者。男25例(74%)，女9例(26%)，男女比例为1∶0.4。平均年龄2.9± 1.5岁（5mo～7岁）。6例(18%)患者为双眼发病，28例(82%)为单眼。所予以的治疗为眼内容物剜除术或眼球摘除术联合化疗。 结论：在发展中国家，由于患者未及时就诊、贫穷、医疗资源匮乏等因素，视网膜母细胞瘤的治疗现状很差。改善其在发展中国家的治疗，应包括健康教育、早期诊断及提供现代化治疗设施。
【关键词】 发展中国家 治疗 视网膜母细胞瘤
INTRODUCTION
Oculoorbital tumors are rare and there are few composite studies of these tumors.Most reported series of the frequency of orbital tumors are based on factors such as a specialy interest of the reviewer, whether only histopathologically confirmed lesions were included, the range of patients age, the geographic area of the patients, and other factors[1]. Reviews that analyze orbital tumor incidence from an ophthalmology practice show a different array of tumors than seen in a neurosurgery or otolaryngology practice[24]. It is important to obtain information about different aspects of orbital tumors to determine the appropriate treatment strategy in order to prevent postoperative visual impairment. Information about the type of tumor is very important when the treatment strategy is detecting[5]. The aim of this study is awareness of demographic, type of oculoorbital tumors based on patients age, location of the tumor, pathological report and follow up studies.
SUBJECTS AND METHODS
Conducted based on retrospective, observational case series study from 1997 to 2007. Two hundred cases are verified oculoorbital tumors in our institution from 1997 to 2007. The oculoorbital excisional biopsy specimen from operation room of Shahid Sadughi and Rahahan Hospital, sent to pathology department. The pathology reports were selected from profiles and data collected in special questionnaire .
All patient who had oculoorbital tumors included in this study and categorized to two age groups of under and over 18 years old.
RESULTS
We studied the relationships between the pathological reports of 200 cases of oculoorbital tumors, their locations and the age of patients at diagnosis time. The sex distribution revealed 111(55.5 %) males versus 89(44.5%) females.The orbital tumors, which were mainly divided into three types, including benign, Malignant and Metastatic tumors of the eye and adnexa are gathered in this study. 110 cases (55.0%) were benign, 86 (43.0%) malignant, and 4 (2.0%) metastatic tumors. Nevus (15.0%), dermoid cyst (5.5%) and hemangioma (5.0%) were the most common benign tumors. There were 90 cases (45.0%) of malignant and metastatic tumors, including BCC 51(25.5%), SCC 12(6.0%) malignant melanoma 11 (5.5%), and sebaceous cell carcinomas 5(2.5%) etc. All of 4(2.0%) metastatic tumors that were reported were metastatic melanoma. The age distribution of patients at diagnosis were recorded.We categorized the tumors by age of under 18 years old and the over 18 years old . In the under 18 years old group (37 cases), the most common tumors were benign (90.1%), and malignant and metastatic tumors were 8.4% and 1.5% respectively,while in patients over 18years (163 cases), the most common tumors were malignant (51.1%), benign tumors (47.1%) and metastatic tumors (1.8%).The relationships between pathological findings and location of the tumors:119 tumors (59.5%) were eyelid tumors, 21 (10.5%) were orbital and 60 cases (30.0%) were in globe.The most common tumors in all three oculoorbital areas are different in childhood and adulthood patients. Eyelid tumors(63.5%) are the most frequent tumors of older patients based on location while the globe tumor(43.0%) were the most frequent tumors in childhood.
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