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Rudolph's PediatricsRudolph's Pediatrics

Section 24. Neoplastic Disorders > 

Part 3. Solid Tumors > 

Chapter 461. Retinoblastoma

Rima F. Jubran and Anna T. Meadows
Topics Discussed: leukocoria; medical oncology; pediatric oncology; retinoblastoma; retinoblastoma, familial ; trilateral retinoblastoma.
Sections: References.
Excerpt:"Retinoblastoma (RB) is the most common primary intraocular malignancy of childhood. Incidence rates vary from 1 in 14,000 to 1 in 22,000 live births, and it is estimated that 300 children develop retinoblastoma in the United States annually.1 There is no race or gender predilection. Approximately 80% of children are diagnosed before the age of 3 years. More than half of patients diagnosed in the first year of life have bilateral disease compared with less than 10% of older children. Retinoblastoma (RB) appears to develop only when both alleles of a tumor suppresser gene (RB1) located on 13q14 are absent or defective. In hereditary RB every cell in the body inherits one absent or defective gene. During normal development, a mutagenic "hit" to the remaining normal allele results in the loss of normal cellular growth regulation and tumor development.2 In sporadic, nonhereditary RB, a single retinal cell must receive 2 mutagenic hits to the 13q14 tumor suppressor gene before RB can be expressed. Point mutations of the RB1 gene are the most common events. Variable deletions of the long arm of chromosome 13 are not commonly found in patients with RB and patients who are developmentally delayed should not be presumed to have the chromosome 13q deletion syndrome.3,4 ..."
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