Retinoblastoma (Rb) is a congenital, malignant primary retinal tumor.

This rare form of cancer that rapidly develops from the immature cells of a retina, the light-detecting tissue of the eye. It is the most common malignant cancer of the eye in children, and it is almost always found in young children.

40% are bilateral,90% are calcified (often a key differentiating feature; does not portend benignity as with other lesions).

Almost all children survive this cancer, although they may lose their vision in the affected eye(s) or need to have the eye removed.

Almost half of the children with retinoblastoma have a hereditary genetic defect associated with retinoblastoma.

Sporadic retinoblastoma and pilocytic astrocytoma: A rare association of two tumors 1).

may show retinal detachment

Intra-arterial chemotherapy (IAC) has become one of the most important pillars in retinoblastoma (Rb) management. It allows for targeted delivery of chemotherapy by superselective catheterization of the ophthalmic artery, thus, reducing systemic toxicity. As in most neurovascular procedures, IAC has traditionally been performed through transfemoral access. However, recent publications have spurred the use of the trans-radial route for neuroendovascular procedures due to its lower complication rates and higher patient satisfaction. They presents the first case series in the literature on the technique, safety, and feasibility of IAC via the trans-radial route in the pediatric population.

Al Saiegh et al. retrospectively analyzed the prospectively maintained database and present the technique and initial experience from 5 consecutive pediatric patients aged between 3 and 15 years who underwent 10 trans-radial IAC treatments.

All IACs were performed successfully. Two patients had repeat IACs through the same wrist. There were no thromboembolic events or access site complications, such as hand ischemia or hematoma. All patients were discharged home the same day of the procedure.

This case series demonstrates the safety and feasibility of transradial IAC in pediatric patients with Rb. As more experience is gained with the transradial route for neurovascular procedures in adults, it may become the preferred route in some pediatric patients as well 2).

De Ioris MA, Carai A, Valente P, Angioni A, Randisi F, Cozza R, Romanzo A, Marras CE, Mastronuzzi A. Sporadic retinoblastoma and pilocytic astrocytoma: A rare association of two tumors. Pediatr Blood Cancer. 2015 Jul 14. doi: 10.1002/pbc.25636. [Epub ahead of print] PubMed PMID: 26173175.
Al Saiegh F, Chalouhi N, Sweid A, Mazza J, Mouchtouris N, Khanna O, Tjoumakaris S, Gooch R, Shields CL, Rosenwasser R, Jabbour P. Intra-arterial chemotherapy for retinoblastoma via the transradial route: Technique, feasibility, and case series. Clin Neurol Neurosurg. 2020 Apr 6;194:105824. doi: 10.1016/j.clineuro.2020.105824. [Epub ahead of print] PubMed PMID: 32283473.
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