Retinoblastoma

Retinoblastoma is a form of cancer that can affect children during fetal development up to five years old. It is caused by immature retinal cells and can affect one or both eyes. Retinoblastoma is the most diagnosed form of eye cancer in children. It is largely believed that this form of cancer develops from a mutation of chromosome 13 (in the long arm). Common signs of retinoblastoma are a white glow in the pupil of the affected eye that is visible in dim lighting. It is also noticeable in color photos by the white appearance of the pupil. Also patients may have crossed eyes or eyes that are not properly aligned.
When patients receive prompt medical care their prognosis is good. The survival rate in the United States and Great Britain is around 85%. If the optic nerve is not involved enucleation is performed before the tumor passes through the lamina cribrosa, in these cases the cure rate is almost 90%. If the tumor extends beyond the lamina cribrosa the survival rate decreases to 60%. Some complications of retinoblastoma survivors can include the development of secondary nonocular tumors (this occurs in 50% of patients who have survived having bilateral retinoblastoma), the development of a cataract, retinal vascular damage and/or hemorrhage.
Patients suffering from retinoblastoma can be treated by radiation treatment, chemotherapy, or surgical removal of the tumor, which is known as enucleation. Enucleation is most commonly performed when the chance of preserving useful vision is unlikely. Patents receiving enucleation are those that have a total retinal detachment.
As retinoblastoma progresses the appearance of the eye becomes worse, and can develop into a large orbital mass in and around the eye. CT images are pivotal in identifying and diagnosing this form of tumor. It also allows the assessment of anatomy for possible extension of the retinoblastoma.
Retinoblastoma is one of the cancers that if discovered early can be successfully treated.

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Craniopharyngioma

Craniopharyngioma is a tumor that develops near a small endocrine gland known as the pituitary gland which is located at the base of the brain. This is a benign type of tumor that commonly affects children between the ages of 5 and 10 years old. It can however develop in older individuals as well.This disease does not affect one sex more than another.
Craniopharyngiomas will affect the body most commonly in these three ways. It causes an increased pressure on the brain (intracranial pressure). It will also disturb the function of the pituitary gland, and it will cause damage to the optic nerve. With the increase of brain pressure patients can expect to experience nausea, vomiting (most commonly in the morning), headaches, and problems with balance. Disturbances in the function of the pituitary gland can cause hormone imbalances which can lead to diabetes insipidus. This presents itself by excessive thirst and urination. Pituitary gland problems can also lead to stunted growth. If the optic nerve is disturbed it will cause vision problems. At the time of diagnosis it is very common for patients to have some form of vision disturbances and a drop in hormone production. Disturbances in vision may be permanent and may worsen if surgery is performed to remove the tumor.
Diagnosis of this type of tumor can be obtained by using a CT or MRI scan of the brain. In the past the treatment for these tumors has been to have them surgically removed. In some patients this may not be the best choice. In these cases radiation treatment will be utilized. In the cases where surgery could not completely remove the tumor radiation therapy will be required.
I n most cases if the tumor can be completely removed or if high doses of radiation are given the prognosis is very good with most patients having an 80-90% chance for a complete cure. The prognosis will vary on a patient by patient basis depending on the severity of their individual symptoms. In most cases the vision problems and hormonal imbalances will not be resolved with the treatment and can become worse because of the treatment.
Some complications associated with the treatment of craniopharyngioma are that a very large percentage of patients will have continuing visual, hormonal and neurological problems. In the cases where the tumor couldn’t be completely removed it is common for the tumor to return.

The image I chose is of a gadolinium enhanced T-1 weighted MRI image of a craniopharyngioma in a 23 year old female.

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http://www.nlm.nih.gov/medlineplus/ency/article/000345.htm

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Glomus Tympanicum Tumor

Glomeus Tympanicum Tumors are tumors that grow in the portion of the ear known as the middle ear. These type tumors are often called neoplasms. Glomerus Tympancium tumors are the most common type of neoplasm found in the middle ear. Symptoms of this type of tumor include hearing a pulsing sound which is known as pulsatile tinnitus. This results from the sound the blood makes as it moves through the vessels of the tumors. The most severe symptom is that of conductive hearing loss which is caused by the tumor blocking the sound through the middle ear. Some of the other symptoms can include ear pain, and bleeding.
The diagnosis process is based on the patients’ symptoms. It is customary for a physical examination to be done first. It is in this examination that a bluish mass is found behind the ear drum. Following this a hearing test and a CT exam are performed. The CT is done to assess the location of the tumor in relation to other structures in the ear. The CT is also used to determine the size of the tumor. The CT scan will also show if there are small erosions in the bones.
Most often these tumors are treated by surgically removing them. The surgeon will remove them by making a small incision in the ear canal to remove the smaller tumors but if the tumor is larger it will be removed by making an incision behind the ear. Although these surgeries are done while the patient is under general anesthesia they are usually done as a same day surgery. If the entire tumor is successfully removed the chance of recurrence is very low.

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www.chicagoear.com/med_info/glomus_tympanicum.htm

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