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要約 目的:網膜芽細胞腫の診断と臨床経過の報告。症例:過去8年間の網膜芽細胞腫の自験例7症例を検索した。結果:男児2例,女児5例で,5例が片眼性,2例が両眼性であった。年齢は6例が4歳以下で,1例が7歳であった。主訴は白色瞳孔と斜視が5例,視力低下が1例,結膜充血と眼瞼腫脹が1例にあった。国際分類での病期はB~Eの範囲にあり,3例がE期であった。初回治療として眼球摘出術を5眼,眼窩内容除去術を1眼に行った。眼球を温存した3眼中,2眼では後に眼球摘出を必要とし,1眼では再発がなかった。眼球摘出術または眼窩内容除去術を行った6眼では転移はなかった。眼球外に浸潤した2例は不帰の転帰をとった。この2例は,初診時に網膜芽細胞腫の典型的所見がなかった。結論:網膜芽細胞腫の初診時の臨床像は,必ずしも予後を示さない。
Abstract. Purpose:To report 7 cases of retinoblastoma regarding initial diagnosis and clinical course. Cases:A retrospective study was made on 7 cases seen during the past 8 years. Results:The series comprised 2 boys and 5 girls. Five cases were unilaterally and two were bilaterally affected. Six cases were younger than 4 years and one was 7 years at the initial diagnosis. Chief complaints comprised leukocoria and squint in 5 cases,impaired vision in one,and hyperemia with edema of eyelid in one. Retinoblastoma was classified from stage B to E. Three eyes were in stage E at the time of diagnosis. Enucleation was performed in 5 eyes and orbital exenteration in one as the initial treatment. Enucleation became necessary in 2 out of 3 eyes that were conservatively treated. There was no metastasis in 6 eyes that received enucleation or exenteration. Two cases that developed extraocular infiltration resulted in fetal outcome. Initial clinical features in these 2 cases did not match with the final outcome. Conclusion:Clinical features of retinoblastoma at the initial diagnosis are not indicative of prognosis.
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