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CT and MRI Features of Recurrent Tumors and Second Primary Neoplasms in Pediatric Patients with Retinoblastoma

Ukihide Tateishi1, Tadashi Hasegawa2, Kunihisa Miyakawa1, Minako Sumi3 and Noriyuki Moriyama1

1 Division of Diagnostic Radiology, National Cancer Center Hospital and Research Institute, 5-1-1, Tsukiji, Chuo-Ku, 104-0045 Tokyo, Japan.
2 Division of Pathology, National Cancer Center Hospital and Research Institute, Chuo-Ku, 104-0045 Tokyo, Japan.
3 Division of Radiation Oncology, National Cancer Center Hospital and Research Institute, Chuo-Ku, 104-0045 Tokyo, Japan.



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  		Fig. 1. —Drawing shows types of tumor extension in recurrent retinoblastoma. Three growth patterns are present in recurrent retinoblastoma: intraocular tumor (type A), intraorbital tumor with local spread into optic nerve (type B), and tumor extending to lateral aspect of orbit and invading brain via sphenoidal bone (type C).

 


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  		Fig. 2. —2-year-old boy with recurrent retinoblastoma who underwent enucleation of left eye and irradiation of both eyes. Axial T2-weighted image (TR/TE, 4000/118) shows soft-tissue mass in right globe (type A). Tumor (arrowheads) shows heterogeneous high signal intensity relative to temporal muscle.

 


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  		Fig. 3. —3-year-old boy with recurrent retinoblastoma who underwent irradiation of left eye. Axial contrast-enhanced T1-weighted image (TR/TE, 630/15) shows recurrent tumor (arrowheads) that extended into optic nerve (type B) with heterogeneous enhancement.

 


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  		Fig. 4. —6-year-old boy with recurrent retinoblastoma who underwent enucleation and irradiation of left eye. Axial contrast-enhanced T1-weighted image (TR/TE, 600/15) shows tumor extension (arrows) through greater wing of sphenoid to middle cranial fossa (type C).

 


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  		Fig. 5. —4-year-old boy with recurrent retinoblastoma who underwent enucleation, irradiation, and chemotherapy. Coronal contrast-enhanced T1-weighted image (TR/TE, 400/15) shows multiple leptomeningeal metastases (arrowheads).

 


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  		Fig. 6. —Osteosarcoma in 25-year-old man with hereditary retinoblastoma who underwent enucleation, irradiation, and chemotherapy of both eyes. Axial CT scan shows faintly calcified mass (arrowheads) of temporal bone invading both brain and soft tissues.

 


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  		Fig. 7. —Rhabdomyosarcoma in 5-year-old girl with retinoblastoma who underwent irradiation in right eye. Axial T2-weighted image (TR/TE, 5700/105) shows well-defined soft-tissue mass arising from deep aspect of temporal muscle. Tumor (arrowheads) shows high signal intensity relative to muscle.

 


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  		Fig. 8. —Malignant fibrous histiocytoma in 16-year-old girl with hereditary retinoblastoma who underwent enucleation and irradiation in right eye. Axial contrast-enhanced CT scan shows irregular mass (arrow) with bone destruction in orbit.

 


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  		Fig. 9A. —Meibomian gland carcinoma in 20-year-old woman with hereditary retinoblastoma who underwent enucleation and irradiation. Axial T1-weighted image (TR/TE, 600/15) shows well-defined soft-tissue mass (arrow) in orbit.

 


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  		Fig. 9B. —Meibomian gland carcinoma in 20-year-old woman with hereditary retinoblastoma who underwent enucleation and irradiation. Axial contrast-enhanced T1-weighted image (600/15) shows marked enhancement of tumor.

 


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  		Fig. 10. —Meningioma in 24-year-old man with hereditary retinoblastoma who underwent enucleation and irradiation. Axial contrast-enhanced T1-weighted image (TR/TE, 600/15) shows extraaxial mass with marked enhancement adjacent to sphenoid bone.

 

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