Failure of Globe Conservation in a Case of Adult Onset Retinoblastoma

Adult onset retinoblastoma is a rare intraocular malignancy. The majority of the cases are treated with enucleation, due to late presentation and advanced-stage tumors. Here we report a case of a 30-year-old female who presented with an intraocular mass with exudative retinal detachment in her right eye. B-scan ultrasound and magnetic resonance imaging (MRI) confirmed the diagnosis of retinoblastoma. In an attempt to salvage the globe, she was treated with chemotherapy, which resulted in excellent regression of the tumor mass by the end of 8 months follow-up. The patient was followed-up regularly with focal treatment whenever necessary. Two years later, she developed a massive recurrence necessitating enucleation. Histopathologic examination revealed a moderately differentiated retinoblastoma with choroidal invasion. Attempt to salvage the globe in adult onset retinoblastoma with chemoreduction and focal therapy may be possible; however, regular long-term follow-up is necessary for recurrence which warrants timely intervention.