Histopathologic verification of Verhoeff's 1918 irradiation cure of retinoblastoma

The authors studied an eye obtained postmortem from the first patient with a successfully irradiated retinoblastoma. This patient, first treated by Verhoeff in 1917, had been followed for 71 years. Ophthalmoscopy disclosed a depressed chorioretinal scar, approximately 3 disc diameters (DD) in size, with baring of the sclera temporal to the macula. This case is historically significant, in that Verhoeff and Reese debated as to whether this tumor regressed spontaneously or secondary to irradiation. Results of histopathologic, immunohistochemical, and ultrastructural examination showed a chorioretinal, neuroglial scar without evidence of calcification, necrotic tumor cells, or residual retinoblastoma. The authors discuss the clinical and histopathologic findings in spontaneously regressed retinoblastoma, retinoma/retinocytoma, and irradiated retinoblastoma. They believe that Verhoeff was correct in his belief that x-ray therapy had cured this patient.