[Prognosis of primary malignant tumors of the conjunctiva]. / Le pronostic des tumeurs malignes primitives de la conjonctive.

PURPOSE: To discuss possible factors that could influence the prognosis of primary malignant conjunctival tumors. PATIENTS AND METHODS: We retrospectively analyzed medical records of 79 patients followed for primary malignant conjunctival tumors between January 1997 and July 2011. RESULTS: The mean age at the time of diagnosis was 61.1 years; male/female ratio was 2.59. The mean tumor size was 13.9 mm. The histological type was invasive squamous cell carcinoma in 43 cases (54.4%), epithelial dysplasia in 11 cases (13.9%), carcinoma in situ in 7 cases, conjunctival malignant melanoma in 5 cases, conjunctival lymphoma in 4 cases and other rare tumors in 9 cases. We performed an excisional biopsy with a safety margin in 89.8% of cases, associated with cryotherapy in 46.6% of cases. Enucleation was performed in two cases and orbital exenteration in 5 cases. We noted tumor recurrence in 33.3% of patients after an average period of 9.5 months. Radiation therapy was indicated in 44 cases (55.7%). The mean follow-up of our patients was 42 months. Tumor recurrences were statistically associated with a history of xeroderma pigmentosum (P=0.012), a diagnostic delay more than 11 months (P=0.001), caruncular location (P=0.004), tumor size greater than 10mm (P=0.044), scleral extension (P=0.011), initial treatment limited to excisional biopsy (P=0.033) and histopathologic involvement of the margin of the tumor resection (P=0.008). CONCLUSION: A better understanding of the prognostic factors of primary malignant conjunctival tumors is essential for management and may improve the prognosis of these tumors.

[Clinical features of retinoblastoma in Tunisia]. / Le profil clinique du rétinoblastome en Tunisie.

PURPOSE: To report the relative frequency of presenting signs in Tunisian children with retinoblastoma and to evaluate their prognostic impact. METHODS: A retrospective study was undertaken of 200 patients with retinoblastoma examined and treated between January 1993 and June 2009. RESULTS: There were 123 boys and 77 girls. For all cases, mean age at diagnosis was 29.8 months (range, 1 month to 9 years). There were 138 (69%) unilateral cases and 62 (31%) bilateral cases. Nineteen children (9.5%) had a family history of retinoblastoma. The most common signs were leukocoria (80%) and strabismus (28%) followed by proptosis. Orbital inflammation, hyphemia and phthisis are rare presenting findings in retinoblastoma. In our series, 26 children (13%) presented with extraocular retinoblastoma. Leukocoria and proptosis are significantly associated with a worse prognosis. CONCLUSION: The ability to recognize the presenting signs and symptoms of retinoblastoma can lead to earlier diagnosis and better prognosis.