Retinoblastoma The Challenges of Management in Ibadan, Nigeria

Background: Retinoblastoma is a common highly malignant tumor of the eye. Late presentation leads to poor survival rate in many developing countries. Objective: To identify problems associated with management of retinoblastoma. Methods: A retrospective review of cases of retinoblastoma at the University College Hospital, Ibadan, between January 1992 and December 2007. Results: A total of 32 eyes of 26 patients were studied. Sixteen were males and 10 were females. Minimum age at presentation was 4 months and maximum age was 60 months (mean 30.69 +/- 14.2 mo). Over 90% presented after 1 month of onset. Reasons for late diagnosis included late presentation for unknown reasons, missed diagnosis, and mismanagement in a previous hospital. Eleven of 26 patients defaulted to avoid removal of the eye, and treatment was only completed in 5 patients. Problems included financial constraint regarding investigations and procurement of drugs, as well as availability of the chemotherapy. Conclusions: Retinoblastoma is a problematic malignancy of childhood associated with management problems often related to difficulty with patients accepting removal of the affected eye and financial constraint for treatment.