A long follow-up of a patient with bilateral retinoblastoma who underwent globe-preserving therapy and had metastasis after 72mo

I am Dr. Yi Zhang, from the Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University,Beijing, China. I would like to describe the metastasis in the left parotid and cervical lymph nodes of a patient with bilateral retinoblastoma 72mo after the initial successful globe-preserving therapies, which included chemotherapy, laser photocoagulation, and cryotherapy.

Synchronous concomitant pancreatic acinar cell carcin and gastric adenocarcinoma:A case report and review of literature

BACKGROUND Multiple primary malignant tumors are two or more malignancies in an individual without any relationship between the neoplasms.In recent years,an increasing number of cases have been reported.However,concomitant primary gastric and pancreatic cancer reported a relatively small incidence,involving no pancreatic acinar cell carcinoma reports.Here,we present the first case of concomitant pancreatic acinar cell carcinoma and gastric adenocarcinoma.CASE SUMMARY A 69-year-old male presented to our department with a history of vomiting,epigastric pain,and weight loss.Imaging revealed space-occupying lesions in the stomach and the tail of the pancreas,respectively.The patient underwent laparo-scopic radical gastrectomy and pancreatectomy simultaneously.The pathologies of surgical specimens were completely different:The resected gastric specimen was moderate to poorly differentiated adenocarcinoma,whereas the pancreatic tumor was consistent with acinar cell carcinoma.The patient was treated with six cycles of oxaliplatin and S-1 chemotherapy.As of March 2021,the patient was healthy without any recurrence or metastasis.After thoroughly reviewing the literature on simultaneous pancreatic and gastric cancers at home and abroad,we discussed the clinical characteristics of these rare synchronous double cancers.Most of the cases had undergone surgery and adjuvant chemotherapy,and all of the cases were pathologically confirmed by the postoperative specimen.CONCLUSION Synchronous pancreatic acinar cells and gastric adenocarcinoma can occur and should be considered when tumors are found in these organs.

Natural killer/T-cell lymphoma with intracranial infiltration and Epstein-Barr virus infection: A case report

BACKGROUND Because of atypical clinical symptoms,lymphoma is easily confused with infectious diseases.Extranodal nasal-type natural killer/T-cell lymphoma(NKTL)is more common,and there are few cases of eyelid site onset and intracranial infiltration,which increases the difficulty of diagnosis.This disease usually has a very poor prognosis and there are few reports of recovery.CASE SUMMARY A 3-year-old boy was admitted to our hospital due to an initial misdiagnosis of"eyelid cellulitis"and failed antibiotic treatment.He was characterized by fever,right eyeball bulging,convulsions,and abnormal liver function.His blood Epstein-Barr virus(EBV)DNA was positive(8.798×10^4 copies/mL),and remained positive for about half a year.The cranial imaging examination suggested a space-occupying lesion in the right eyelid,with the right temporal lobe and meninges involved.The boy underwent ocular mass resection.The pathological diagnosis was NKTL.He was diagnosed as having NKTL with intracranial infiltration,combined with chronic active EBV infection(CAEBV).Then he underwent systemic chemotherapy and intrathecal injection.The boy suffered from abnormal blood coagulation,oral mucositis,diarrhea,liver damage,and severe bone marrow suppression but survived.Finally,the tumor was completely relieved and his blood EBV-DNA level turned negative.The current follow-up has been more than 2 years and his condition is stable.CONCLUSION This case suggests that chemotherapy combined with intrathecal injection may have a good effect on intracranial infiltrating lymphoma and CAEBV,which deserves further study and discussion.

Clinical analysis of 2790 children with retinoblastoma: a single-center experience in China

Background In this study,we aimed to analyze the clinical characteristics and prognosis of children with retinoblastoma(RB)in a single center in China with a large sample collection spanning 17 years.Methods The clinical data of 2790 children with RB treated in Beijing Tongren Hospital from 2005 to 2021 were collected,and a retrospective analysis was conducted.Results The median age of the participants was 28.3 months.There were 3624 affected eyes,12.4%of which were in groups A–C,67.1%in groups D–E and 16.2%were not specified.The primary symptom observed in most cases was a white pupil,accounting for 66.5%,followed by strabismus(12.8%).The median follow-up time was 59.7 months.The enucleation rate was 71.3%(703/986)in a single left eye and 72.5%(702/968)in a single right eye.The overall survival(OS)rate was 95.8%(2444/2552)because 237 patients dropped out,and 109 died.Kaplan‒Meier survival analysis showed that the median survival time(MST)was 125.92 months[95%confidence interval(CI)=124.83–127.01].Cox multivariate survival analysis showed that trilateral RB(P=0.017),metastasis site(P=0.001),and combined distant tissue metastasis(P=0.001)were independent prognostic factors for RB.The OS of 44 cases of familial RB was 93.2%(41/44),with an MST of 80.62 months(95%CI=67.70–93.54).Conclusions The timing of eye protection treatment and enucleation should be comprehensively judged to avoid worsening prognosis due to operation time delay.More importantly,the promotion and popularization of diagnosis and treatment technologies are necessary to further improve RB prognosis.