A 5 yr old boy presented with leukocoria in right eyeball diagnosed to be retinoblastoma involving full eyeball, while other eye had 2-3 small lesions in the periphery. What will be the ideal management for this patient?
**Core Concept**
Retinoblastoma is a malignant tumor of the retina, most commonly affecting children. The management of retinoblastoma involves a multidisciplinary approach, including chemotherapy, radiation therapy, and surgery, depending on the extent of the disease.
**Why the Correct Answer is Right**
In this scenario, the patient has a unilateral retinoblastoma with a large tumor in one eye and small peripheral lesions in the other eye. The ideal management would be enucleation of the affected eye with the large tumor, followed by chemotherapy to treat any potential residual disease or metastasis. This approach is known as the "ice" protocol (enucleation, chemotherapy, and local treatment). The goal is to preserve the life of the child while removing the tumor.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because enucleation alone may not be sufficient to treat the disease, especially if there are small peripheral lesions in the other eye.
**Option B:** This option is incorrect because chemotherapy alone may not be enough to treat the large tumor in one eye, and enucleation is usually necessary to remove the tumor.
**Option C:** This option is incorrect because radiation therapy may not be the best option for a child with a unilateral retinoblastoma, and chemotherapy and enucleation are usually preferred.
**Clinical Pearl / High-Yield Fact**
Retinoblastoma is the most common intraocular malignancy in children, and early detection is crucial for effective treatment and preservation of vision.
**Correct Answer:** C. Enucleation of the affected eye followed by chemotherapy.