Retinoblastoma in Ethiopian Children: Imaging Findings and Staging

Abstract

BACKGROUND: Retinoblastoma is the most prevalent intraocular retinal malignancy in children worldwide. Accurate staging is critical for treatment planning and relies heavily on radiologic imaging and clinical findings. This study aims to evaluate imaging patterns and staging of retinoblastoma in children at Tikur Anbessa Specialized Hospital (TASH).

MATERIALS AND METHODS: This cross-sectional study analyzed retrospective data from TASH between September 2018 and September 2021. It focused on patients diagnosed with retinoblastoma who underwent Computed Tomography (CT) scans or Magnetic Resonant Imaging (MRI) and had pathology results available. Two radiologists, each with over 10 years of experience, independently reviewed the scans. Supplementary data were gathered from the pediatric oncology unit registry using structured questionnaires. The International Retinoblastoma Staging System (IRSS) was used to stage extraocular disease based on cross-sectional imaging and the International Intraocular Retinoblastoma Classification (IIRC) for intraocular disease classification.

RESULTS: Eighty-three patients were included, with 42 (50.6%) males and 41 (49.4%) females. The mean age at presentation was 3.4 ± 2 years. The most common clinical symptoms were proptosis (42 patients, 50.6%) and leukocoria (37 patients, 44.6%). Clinical staging revealed 63 (75.9%) patients in Group E, 19 (22.9%) in Group D, and 1 (1.2%) in Group C according to IIRC. Stage IV disease was predominant, with 33 (39.2%) in Stage IVA and 18 (21.4%) in Stage IVB according to IRSS.

CONCLUSION: Most patients presented with advanced retinoblastoma, particularly Stage IV. This underscores the need for community awareness of early signs and symptoms of retinoblastoma, promoting timely medical consultation.