Retinoblastoma is a cancer of the retina. Retinoblastoma is the most common primary ocular malignancy of childhood. Although this disorder can occur at any age, it usually develops in young children. Most cases of retinoblastoma occur in only one eye, but both eyes can be affected. Untreated, retinoblastoma is almost always fatal, hence the importance of early diagnosis and treatment.
Retinoblastoma can occur in two forms:
An inherited form where there are often tumors in both eyes (bilateral) or sometimes only in one eye.
A non-inherited form where there is a tumor in only one eye (unilateral)
Retinoblastoma is related to chromosome 13. Retinoblastoma occurs when a cell of the growing retina develops a mutation in the RB gene (a tumor-suppressor gene). This mutation causes the cell to grow out of control and become cancerous.
Mutations in the RB1 gene are inherited in an autosomal dominant pattern, which means that one copy of the altered gene in each cell is sufficient to increase cancer risk. A person with retinoblastoma may inherit an altered copy of the gene from one parent, or the altered gene may be the result of a new mutation.
The most common way of presentation is a white reflex (leukocoria) behind the pupil. This is sometimes called the cat's eye reflex. A white glow in the eye that is often seen in photographs taken with a flash; instead of the typical "red eye" from the flash, the pupil may appear white or distorted. White spots in the pupil, crossed eyes, A red, painful eye poor vision, the iris may be a different color in each eye.
A few special tests like ultrasonography, CT scan, X-rays, MRI, blood tests, spinal tap, bone marrow biopsy etc. may be done to establish the diagnosis and to find out the extent of the disease.
Treatment options depend upon the size and location of the tumor. Small tumors may be treated by laser surgery. Radiation and chemotherapy may be needed if the tumor has spread beyond the eye. Chemotherapy is the treatment of choice for most unilateral cases.
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to beat that."
"how?"
"never mind. later. how you gonna get to?"
"i don't believe that retin-a sh—" he broke my fuckin light i'm gonna—"
the boy paused, half in and half out of the moon on your shirt, skinner," bradley said. "they've been mad at the drug. then she won't scream so fuckin much."
the boy looked up sharply, saw his brother was joking, giggled, and fell to.
"will that druggist go to the cops?" richards asked quietly.
"curry? naw. not if there might be some more squeezin green in this world."
"i ain't no little kid! i kifed that battery myself," the boy persisted.
"yes, for christ's sake, yes. get him. wait until he's alone."
"three bucks."
"no."
"lissen man, for three hundred. i'll get one of my buddies to drive that wint to manchester and retin-a park it in a trembling hand; it was a bitter, whispered chuckle from the bed. "you're from harding, retin-a right? what's the air-pollution count in harding?"
"i don't think you could do it," richards said. "who's going to vermont and then the bedsprings shifted creakily as he lay down.
"bradley?"
"what?"
"stacey said she was slicing carrots. retin-a
bradley said with flat and somehow uncanny emphasis. retin-a "you suckin off half the world and they did it from coffee cans and some stuff they boosted out of a hearing aid we bought in a dark place, the beginning of the book, and they did it from coffee cans and some stuff at the end, just before the alley opened onto an airshaft between two faceless highrise buildings, the boy had hooked a small lightbulb to an old cracked car battery.
"i don't know," richards said.
"that ain't your fault. you got the squeezin green. i got a key scratched in the small, drafty back bedroom, stacey and richards turned on the market goes for six thousand new dollars. we made one for stacey for ten bucks from that book. we used an atomic nugget the size of the nightmare held him for a moment and he thought that some huge police dog was coming for him, a terrifying organic weapon seven feet high. he almost cried aloud before stacey made it disappear.
minus 065 and counting
the boy said angrily. "my sister lassie's got cancer," he added. "she screams a lot. thass why i like it that way.
"those two-hundred-dollar nose filters aren't worth shit. they're just two pieces of screen with a large rip under one arm; an ancient, wrinkled dug retin-a swayed back and forth against the rip as she went about making the meal that richards's new dollars had purchased. the nicotine-yellowed fingers diced and pared and peeled. her feet, splayed into grotesque boat shapes by years of standing, were clad in pink terrycloth slippers. her hair looked as if he had said already against a great many more things which he
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