Solitary Retinal Astrocytoma: A Case Series

Takafumi Fuchino, Tomayoshi Hayashi, Kiyoshi Suzuma, Asuka Taneoka, Kuniko Abe, Naoe Kinoshita, Haruna Yasui, Takashi Kitaoka, Junya Fukuoka

.
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan.

DOI: 10.4236/ojpathology.2013.32011                

Abstract

Background: Astrocytic tumors of the retina are rare. We report and discuss the clinical features of two cases of retinal astrocytoma along with presenting a current literature review. Case Presentation: Case 1 was a 46-year-old Japanese female who became aware of her decreased visual acuity. A fundus photograph indicated the presence of a 5 mm hemispherical yellow-white tumor, retinal edema and hard exudate around the tumor. In case 2, a 36-year-old Japanese female became aware of her myodesopsia, and presented with a retinal tumor and vitreous hemorrhage in her right eye. Since the tumors occurred in the peripheral retina in both cases, endoresections were performed. Histological examination showed that the tumors were composed of spindle-shaped cells with small nuclei, which was consistent with astrocytes. Conclusion: Pathologically, it can be difficult to differentiate astrocytic tumors. Therefore, when making a diagnosis, it is important that comprehensive examinations be done in conjunction with the clinical findings. Since retinal astrocytoma has a favorable prognosis, provided proper treatment is administered, utilization of endoresection for peripheral astrocytoma may be advantageous in this patient group.

Keywords

Retina; Astrocytoma; Pathology

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	R. J. Font, J. O. Croxatto and N. A. Rao, “AFIP Atlas of Tumor Pathology Series 4, Tumors of the Eye and Ocular Adnexa,” American Registry of Pathology, Washington DC, 2006.
[2]	C. L. Shields, J. A. Shields, R. C. Eagle Jr. and F. Cangemi, “Progressive Enlargement of Acquired Retinal Astrocytoma in 2 Cases,” Ophthalmology, Vol. 111, No. 2, 2004, pp. 363-368. doi:10.1016/j.ophtha.2003.05.009
[3]	A. C. Arnold, R. S. Hepler, R. W. Yee, J. Maggiano, L. F. Eng and R. Y. Foos, “Solitary Retinal Astrocytoma,” Survey of Ophthalmology, Vol. 30, No. 3, 1985, pp. 173-181. doi:10.1016/0039-6257(85)90061-X
[4]	T. M. Ulbright, K. H. Fulling and E. M. Helveston, “Astrocytic Tumors of the Retina. Differentiation of Sporadic Tumors from Phakomatosis-Associated Tumors,” Archives of Pathology & Laboratory Medicine, Vol. 108, No. 2, 1984, pp. 160-163.
[5]	S. D. Deshmukh, A. V. Ashturkar, S. V. Babanagare, S. K. Gokhale and A. A. Deshpande, “Massive Retinal Gliosis: An Unusual Case with Immunohistochemical Study,” Indian Journal of Ophthalmology, Vol. 59, No. 3, 2011, pp. 246-248. doi:10.4103/0301-4738.81050
[6]	J. A. Shields, R. C. Eagle Jr., C. L. Shields and B. P. Marr, “Aggressive Retinal Astrocytomas in Four Patients with Tuberous Sclerosis Complex,” Transactions of the American Ophthalmological Society, Vol. 102, 2004, pp. 139-147, Discussion 147-148.
[7]	E. de Juan Jr., W. R. Green, P. K. Gupta and E. C. Baranano, “Vitreous Seeding by Retinal Astrocytic Hamartoma in a Patient with Tuberous Sclerosis,” Retina, Vol. 4, No. 2, 1984, pp. 100-102. doi:10.1097/00006982-198400420-00005
[8]	J. A. Lee, P. Harvey, R. D. Finlay and P. J. Berry, “Solitary Astrocytoma of the Retina in a Child,” British Journal of Ophthalmology, Vol. 80, 1996, pp. 674-675. doi:10.1136/bjo.80.7.674-a
[9]	W. M. Boles, T. C. Naugle and C. L. M. Samson, “Glioma of the Optic Nerve,” Archives of Ophthalmology, Vol. 59, No. 2, 1958, pp. 229-231. doi:10.1001/archopht.1958.00940030097008
[10]	R. Y. Foos, B. R. Straatsma and R. A. Allen, “Astrocytoma of the Optic Nerve Head,” Archives of Ophthalmology, Vol. 74, No. 3, 1965, pp. 319-326. doi:10.1001/archopht.1965.00970040321006
[11]	G. W. Cleasby, W. E. Fung and W. B. Shekter, “Astrocytoma of the Retina. Report of Two Cases,” American Journal of Ophthalmology, Vol. 64, No. 3, 1967, pp. 633-637.
[12]	J. Jordano, H. Galera, M. Toro and B. Carreras, “Astrocytoma of the Retina. Report of a Case,” British Journal of Ophthalmology, Vol. 58, No. 5, 1974, pp. 555-559. doi:10.1136/bjo.58.5.555
[13]	F. H. Reeser, T. M. Aaberg and D. L. Van Horn, “Astrocytichamartoma of the Retina Not Associated with Tuberous Sclerosis,” American Journal of Ophthalmology, Vol. 86, No. 5, 1978, pp. 688-698.
[14]	R. C. Ramsay, J. L. Kinyoun, C. W. Hill, U. P. Aturaliya and W. H. Knobloch, “Retinal Astrocytoma,” American Journal of Ophthalmology, Vol. 88, No. 1, 1979, pp. 32-36.
[15]	F. A. Jakobiec, S. E. Brodie, B. Haik and T. Iwamoto, “Giant Cell Astrocytoma of the Retina. A Tumor of Possible Mueller Cell Origin,” Ophthalmology, Vol. 90, No. 12, 1983, pp. 1565-1576.
[16]	N. Bornfeld, E. P. Messmer, G. Theodossiadis, G. Meyer-Schwickerath and A. Wessing, “Giant Cell Astrocytoma of the Retina. Clinicopathologic Report of a Case Not Associated with Bourneville’s Disease”, Retina, Vol. 7, No. 3, 1987, pp. 183-189. doi:10.1097/00006982-198700730-00009
[17]	A. Sharma, J. Ram and A. Gupta, “Solitary Retinal Astrocytoma,” Acta Ophthalmologica (Copenhagen), Vol. 69, No. 1, 1991, pp. 113-116. doi:10.1111/j.1755-3768.1991.tb02006.x
[18]	S. Song and M. S. Seo, “Spontaneous Regression of a Solitary Astrocytoma of the Optic Disk,” Retina, Vol. 2, No. 4, 2002, pp. 502-503. doi:10.1097/00006982-200208000-00020
[19]	D. Vilaplana, M. Castilla, V. Poposki, F. Alameda and C. L. Shields, “Acquired Retinal Astrocytoma Managed with Endoresection,” Retina, Vol. 26, No. 9, 2006, pp. 1081-1082. doi:10.1097/01.iae.0000254888.63519.3c
[20]	V. M. Cohen, C. L. Shields, M. Furuta and J. A. Shields, “Vitreous Seeding from Retinal Astrocytoma in Three Cases,” Retina, Vol. 28, No. 6, 2008, pp. 884-888. doi:10.1097/IAE.0b013e3181669781
[21]	S. Eskelin, P. Tommila, T. Palosaari and T. Kivela, “Photodynamic Therapy with Verteporfin to Induce Regression of Aggressive Retinal Astrocytomas,” Acta Ophthalmologica, Vol. 86, No. 7, 2008, pp. 794-799. http://onlinelibrary.wiley.com/doi/10.1111/j.1755-3768.2007.01151.x/pdf doi:10.1111/j.1755-3768.2007.01151.x
[22]	S. R. Drummond and E. G. Kemp, “Retinal Astrocytoma Managed by Brachytherapy,” Ophthalmology, Vol. 116, No. 3, 2009, pp. 597-597. doi:10.1016/j.ophtha.2008.12.008