Oeil et cancer

Résumé Le cancer implique rarement l'oeil et risque d'être reconnu tardivement. Les tumeurs intraoculaires primaires les plus fréquentes sont le rétinoblastome chez l'enfant et le mélanome uvéal chez l'adulte.Le diagnostic différentiel d'une baisse de vision dans un contexte de cancer systémique est varié. Des métastases uvéales sont souvent associées au cancer du sein ou du poumon. Un masquerade syndrome est l'atteinte oculaire, pseudo-inflammatoire, d'un lymphome primaire non hodgkinien du système nerveux central. Un traitement oncologique médicamenteux ou radique peut induire une toxicité, souvent rétinienne. Les syndromes paranéoplasiques, rares, sont causés par des anticorps anticancéreux réagissant contre la rétine. Si le cancer touche l'oeil, référer le patient rapidement vers un centre spécialisé pourra faire la différence aux niveaux pronostiques vital et visuel. Abstract Cancer involves so rarely the eye that it may be recognized late. The most frequent primary intra-ocular tumours are retinoblastoma in small children and uveal melanoma in adults.Vision loss in systemic cancer has a varied differential diagnosis. Uveal metastases are most often associated with breast cancer, but can herald lung carcinoma. Masquerade syndrome looks like infllammation but represents the ocular involvement of primary CNS non-Hodgkin lymphoma. Systemic cancer drugs, as well as radiotherapy, can cause ocular toxicity, mostly at the retina. In the rare paraneoplastic syndromes, patient's cancer antibodies cross-react with retinal antigens, leading to severe vision loss. When cancer involves the eye, a fast referral into specialized care can signifiicantly improve visual and vital prognosis.

MRI-based assessment of the pineal gland in a large population of children aged 0-5Â years and comparison with pineoblastoma: part I, the solid gland.

INTRODUCTION: Differentiation between normal solid (non-cystic) pineal glands and pineal pathologies on brain MRI is difficult. The aim of this study was to assess the size of the solid pineal gland in children (0-5 years) and compare the findings with published pineoblastoma cases. METHODS: We retrospectively analyzed the size (width, height, planimetric area) of solid pineal glands in 184 non-retinoblastoma patients (73 female, 111 male) aged 0-5 years on MRI. The effect of age and gender on gland size was evaluated. Linear regression analysis was performed to analyze the relation between size and age. Ninety-nine percent prediction intervals around the mean were added to construct a normal size range per age, with the upper bound of the predictive interval as the parameter of interest as a cutoff for normalcy. RESULTS: There was no significant interaction of gender and age for all the three pineal gland parameters (width, height, and area). Linear regression analysis gave 99 % upper prediction bounds of 7.9, 4.8, and 25.4 mm(2), respectively, for width, height, and area. The slopes (size increase per month) of each parameter were 0.046, 0.023, and 0.202, respectively. Ninety-three percent (95 % CI 66-100 %) of asymptomatic solid pineoblastomas were larger in size than the 99 % upper bound. CONCLUSION: This study establishes norms for solid pineal gland size in non-retinoblastoma children aged 0-5 years. Knowledge of the size of the normal pineal gland is helpful for detection of pineal gland abnormalities, particularly pineoblastoma.