Prolonged survival of a child with metastatic retinoblastoma

A boy was discovered to have retinoblastoma in his right eye at age 29 months. The eye was enucleated and showed inversion of the choroid and optic nerve on examination. Bone marrow aspiration was negative in January 1981. Orbital recurrence was noted 1 month later and bone marrow aspiration was positive 2 months later. MAD-DOC* chemotherapy and radiation therapy to the right orbit and brain were initiated immediately. The tumor has remained in remission since completion of the chemotherapy 18 months later. A preleukemic syndrome occurred in July 1984, and a successful bone marrow transplantation was performed in November 1984. He resumed normal growth and has remained well. Metastatic retinoblastoma should no longer be thought of as invariably fatal.