1. 1 Department of head and neck tumors, SRI of pediatric oncology and hematology of N.N.Blokhin Cancer Research Center RAMS, Moscow, Russian Federation 2 Pathology Anatomy, SRI of clinical oncology of N. N. Blokhin Cancer Research Center RAMS, Moscow, Russian Federation 3 Department of Ocular Oncology and Radiology, Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russian Federation 4 Pathology Anatomy, Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russian Federation 5 Department of chemotherapy of hemoblastoses, SRI of pediatric oncology and hematology of N.N.Blokhin Cancer Research Center RAMS, Moscow, Russian Federation 6 Department of BMT, SRI of pediatric oncology and hematology of N.N.Blokhin Cancer Research Center RAMS, Moscow, Russian Federation The case of the combined surgical approach for extraocular retinoblastoma Tatiana Ushakova. 1, Svetlana Saakyan 3, Igor Dolgopolov 6, Tatiana Gorbunova 1, Olga Gorovtzova O. 1, Rodion Fu 1, Alla Pavlovskaya 2, Inna Horoshilova-Maslova 4, Evgeniya Stolyarova 5, Vladimir Polyakov 1.

2. Purpose To reduce the risk of metastasis for extraocular RB with preсhiasmatic invasion of the optic nerve using of the combined neuro-ophthalmological operations for a maximum radical surgery.

3. Methods SIAC Unilateral RB with preсhiasmatic tumor invasion of the optic nerve was detected in a boy of five years in May 2012 based on ophthalmic examination, ultrasound and MRI. Before treatment

4. Methods  The patient had neoadjuvant chemotherapy and after it achieved part reduction of intraocular tumor and the presence of physiological symmetric contrast both of the optic nerve according to MRI. After 3 cycles CVC Before treatment

5. Methods  Combined surgical intervention performed in the volume of preсhiasmatic resection of the optic nerve and enucleation of the left eye followed by chemoradiotherapy. orbitozygomatic approach

6. Results and Conclusions  It is necessary to note the presence of therapeutic pathomorphosis found in histological preparations of the eye and the optic nerve in the form of gliosis as substitution reactions to treatment.  The patient is alive with a period of follow-up of 16 months.  This experience shows the possibility of the improved control after using the combined surgery RB with preсhiasmatic invasion of the optic nerve.

7. Thank you very much for your attention