Intraocular Tumors Fall 2024

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Questions and Answers

What characterizes benign tumors compared to malignant tumors?

They can cause fatal outcomes if untreated.

They display unregulated faster growth.

They generally can invade other tissues.

They do not invade other tissues. (correct)

What is a common feature of hamartomas?

They are found in an abnormal location.

They consist of microscopically normal tissues.

They are typically malignant.

They are composed of tissue normally found at the same site. (correct)

Which of the following best describes choristomas?

They are always benign and non-functional.

They are a type of malignant tumor.

They typically invade local tissues.

They consist of abnormally located normal cells/tissues. (correct)

Which type of ocular tumor may still affect vision despite being benign?

Benign ocular tumors. Signup and view all the answers

Which characteristic is NOT typical of malignant tumors?

They grow slowly. Signup and view all the answers

What is the main clinical implication of intraocular lymphomas and leukemias?

They generally have a poor prognosis if untreated. Signup and view all the answers

What is a defining feature of intraocular metastases?

They arise from distant primary tumors. Signup and view all the answers

In distinguishing between benign and malignant tumors, which aspect is most critical?

The capacity to invade adjacent tissues. Signup and view all the answers

What is the inheritance pattern associated with the congenital form of retinoblastoma?

Dominant inheritance if inherited from parents Signup and view all the answers

Which of the following characteristics is true for sporadic retinoblastoma cases?

They account for a higher percentage of cases compared to congenital forms. Signup and view all the answers

Which of these clinical features is NOT commonly associated with retinoblastoma?

Increased intraocular pressure Signup and view all the answers

What imaging technique is typically used to aid in the diagnosis of retinoblastoma?

Ultrasonography Signup and view all the answers

How many mutations of the RB1 gene are typically required for the development of retinoblastoma?

Two mutated copies Signup and view all the answers

Which of the following is a characteristic associated with the bilateral form of retinoblastoma?

More likely to be congenital Signup and view all the answers

What is the typical age of diagnosis for sporadic retinoblastoma cases?

Within 2 years of life Signup and view all the answers

Which of the following is a common treatment approach for retinoblastoma?

Chemotherapy Signup and view all the answers

Which characteristic is associated with exophytic growth in retinoblastoma?

Tumor grows in the subretinal space Signup and view all the answers

What is a primary feature of diffuse infiltrating retinoblastoma?

Sheet-like dissemination without detectable mass Signup and view all the answers

What prognosis classification system predicts outcomes for intraocular retinoblastoma after chemotherapy and focal laser treatment?

International Classification of Retinoblastoma Signup and view all the answers

Which statement about far-advanced cases of retinoblastoma is correct?

Secondary angle closure glaucoma can occur Signup and view all the answers

In diffuse infiltrating retinoblastoma, it is most likely to be misdiagnosed as what?

Inflammatory disease Signup and view all the answers

What typically indicates a far-advanced case of retinoblastoma?

Intracranial extension of the tumor Signup and view all the answers

What distinguishes endophytic growth from exophytic growth in retinoblastoma?

Endophytic growth does not allow appreciation of retinal vessels Signup and view all the answers

What is the typical demographic for diffuse infiltrating retinoblastoma?

Usually unilateral in somewhat older children Signup and view all the answers

Which type of cancer is estimated to have the highest number of new cases in 2024?

Breast Signup and view all the answers

What is the estimated number of deaths due to lung cancer in 2024?

125,070 Signup and view all the answers

How many estimated new cases of melanoma of the skin are projected in 2024?

100,640 Signup and view all the answers

Which type of cancer has the lowest estimated new cases in 2024?

Eye and orbit Signup and view all the answers

Which of the following cancers is estimated to have more deaths in 2024 than melanoma of the skin?

Colorectum Signup and view all the answers

What is the estimated number of new colorectal cancer cases in 2024?

152,810 Signup and view all the answers

What is the estimated number of deaths caused by leukemia in 2024?

23,670 Signup and view all the answers

Which cancer type has a higher estimated death rate in 2024, prostate or NH-Lymphoma?

Prostate Signup and view all the answers

What was the main reason for the shift from radiation to chemotherapy in managing retinoblastoma?

Radiation caused non-ocular secondary cancers. Signup and view all the answers

Which classification group indicates a retinoblastoma tumor size of ≤ 3 mm confined to the retina?

Group A Signup and view all the answers

In which stage does the tumor begin spreading outside the eye to the orbit or nearby lymph nodes?

Stage 3 Signup and view all the answers

What does Group E classification for retinoblastoma indicate?

Tumor has reached the lens or pupil and may infiltrate the wall of the eyeball. Signup and view all the answers

Following enucleation, when is the tumor classified as Stage 2?

When the tumor has infiltrated the sclera. Signup and view all the answers

Which group is classified as 'moderate risk' for retinoblastoma?

Group C Signup and view all the answers

What does Stage 4b signify in extraocular retinoblastoma?

Spread including the spinal fluid or brain. Signup and view all the answers

Which statement is true regarding the risk classifications of retinoblastoma?

Group C tumors produce fluid under the retina. Signup and view all the answers

Study Notes

Most Common Cancers

Breast Cancer: 2,260,000 cases globally
Lung Cancer: 2,210,000 cases globally
Colorectal Cancer: 1,930,000 cases globally
Prostate Cancer: 1,410,000 cases globally
Skin Cancer (non-melanoma): 1,200,000 cases globally
Stomach Cancer: 1,090,000 cases globally

Estimated New Cases in 2024

Breast Cancer: 313,510 cases (USA)
Prostate Cancer: 299,010 cases (USA)
Lung Cancer: 234,580 cases (USA)
Colorectal Cancer: 152,810 cases (USA)
Melanoma of Skin: 100,640 cases (USA)
Non-Hodgkin Lymphoma: 80,620 cases (USA)
Leukemia: 62,770 cases (USA)
Brain/Nervous System: 25,400 cases (USA)
Eye and Orbit Tumors: 3,320 cases (USA)

Estimated Deaths in 2024

Lung Cancer: 125,070 deaths (USA)
Colorectal Cancer: 53,010 deaths (USA)
Breast Cancer: 42,780 deaths (USA)
Prostate Cancer: 35,250 deaths (USA)
Leukemia: 23,670 deaths (USA)
Non-Hodgkin Lymphoma: 20,140 deaths (USA)
Brain/Nervous System: 18,760 deaths (USA)
Melanoma of Skin: 8,290 deaths (USA)
Eye and Orbit Tumors: 560 deaths (USA)

Learning Objectives

Understand basic oncology and tumor terminology
Identify features and differentials of:
- Most common retinal tumors
- Most common uveal tumors
- Most common optic nerve tumors
- Most common intraocular metastases
- Intraocular lymphoma and leukemia

Basic Oncology Terminology

Benign Tumors: Non-invasive, slow-growing, typically not fatal, can still impair vision.
Malignant Tumors: Invasive, destructive, can metastasize, potentially fatal if untreated.

Tumor Characterization

Hamartoma: Benign growth of normal tissue at its site.
Choristoma: Benign growth of normal tissue in an abnormal location.

Retinoblastoma Overview

Caused by mutations in the RB1 gene (recessive tumor suppressor).
Congenital Form: Present at birth, higher risk for other cancers. 30% of cases.
Sporadic Form: Commonly diagnosed within two years, unilateral in most cases.

Clinical Features of Retinoblastoma

Initial appearance as small, transparent; develops into a dome-shaped mass.
Associated with leukocoria (white pupil) and worsening vision.

Diagnostic Approaches for Retinoblastoma

Utilize clinical history, slit lamp biomicroscopy, ophthalmoscopy, and imaging methods such as MRI and ultrasound.

Growth Patterns of Retinoblastoma

Exophytic Growth: Growth in subretinal space, leading to retinal detachment.
Diffuse Infiltrating Retinoblastoma: Unilateral, no detectable mass, often misdiagnosed.

Classification Systems for Retinoblastoma

Reese-Ellsworth Classification: Predicts prognosis after treatment.
International Classification: Evaluates intraocular retinoblastoma treatment outcomes.

Staging of Extraocular Retinoblastoma

Stage 0: Intraocular only.
Stages 1-4: Progressively involve optic nerve, orbit, or distant metastasis.

General Notes

Emphasis on recognizing clinical features for prompt referral to specialists.
Familiarity with definitions and classifications is essential, though memorization of specific classification details is not mandatory.

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Description

This quiz focuses on intraocular tumors, exploring their prevalence, types, and related statistics based on the 2020 WHO report. Gain insights into the most common cancers and their impact on ocular health. Perfect for students and professionals in optometry and oncology.