Retinoblastoma in Nepal: case report and review

Stephen V Lau, Ben Limbu

Abstract

Retinoblastoma often sparks interest because the underlying cancer gene mutation was the first to be identified and cloned. However, apart from its genetic intrigue, the condition illustrates the health disparities between more and less developed countries. We present a case of retinoblastoma in a 6 month old boy who presented with left eye leukocoria and slight proptosis to the Tilganga Institute of Ophthalmology in Kathmandu, Nepal. Urgent left eye enucleation with orbital implant under general anaesthesia was recommended. Histological examination of the left globe revealed gross involvement of the choroid and optic nerve and poorly differentiated tumour cells. The tumour was staged as pT4a in the TNM classification system and 6 cycles of adjunctive chemotherapy were advised. The epidemiology of retinoblastoma between Nepal and developed countries is compared. We propose reasons for the apparent discrepancy between the two settings and identify areas of weakness which can be improved in Nepal.

Keywords: retinoblastoma, leukocoria, enucleation