Caroline Tsimi Mvilongo
University of Yaoundé, France
Caroline Mvilongo Tsimi has completed her MD degree from Yaounde Faculty of Medicine and Biomedical Sciences. She is an Ophthalmologist at Yaounde Central Hospital and has published some papers in reputed journals.
Introduction: Retinoblastoma is an embryonal tumor of neuroectodermal origin, highly malignant affecting the young child and the infant. It is bilateral in 40% of cases. It is of good prognosis if the diagnosis has been taken earlier. We report 2 clinical cases of bilateral retinoblastoma with extra retinal diffusion which is a poor prognosis factor. Case 1: DW , 20 months brought in our ophthalmology service in 2009 with a tumor of the left eye since one month with a past history of leucocoria since birth. A first CT scan has been ask 8 months before but not done by the family. At the ophthalmology exam, he was classified at stage V of Reese-Ellsworth for the contralateral right eye and orbital extension of the left eye. A CT scan has been done showing bilateral calcifications with bilateral orbital extension. He has been enucleated for the left eye and received 3 doses of chemotherapy. The patient was lost of view 2 months after the surgery. Case 2: HO, 3 years Centrafican refugee referred in our ophthalmology service on June 2015 for the care of a tumor of the right eye since 3 months. She had a leucocoria in the right eye since one year; she is the last of a family of 9 with past history of 1st degree consanguinity. The ophthalmology exam showed a great tumor with necrosis and inflammation of the right eye. At the left eye, sub-retinal with mass with retinal detachment stage V of Reese-Ellsworth, she has received neoadjuvant chemotherapy and exenteration of the right eye. She died few hours after the surgery. Discussion: These 2 cases have been seen late in an appropriate ophthalmology unit. The prognosis was poor because of the extra retinal diffusion of the tumor mainly through the optic nerve and the sclera. According to the literature, the mean age of diagnosis is 11 months for bilateral retinoblastoma. The factors that could explain the late of our patient are the using of traditional medicine, the socio-economic status, the ignorance of the gravity by the parents and the inadequate health care unit. Conclusion: Bilateral retinoblastoma is relatively present in our milieu. It should be taken care earlier and people at risk should be sensitized about the disease which is highly malignant and could lead to death if not adequately treated.