Presentation
Right side proptosis for 8 months.
Patient Data
Large heterogeneous mass replacing the entire right eye globe extending along the course of the right optic nerve through the widened orbital bony apex to the level of the optic chiasm. The lesion shows dense calcifications as well. The size of the lesion in the orbital cavity is about 2.8 x 2.9 x 3.1 cm.
There is an avidly enhancing extra-axial lesion of the skull at the left frontal bulging inward to the cranial fossa.
There is also thick meningeal enhancement along inferior aspects of bilateral lateral sulci.
Case Discussion
Various features of metastasis are seen in this case of retinoblastoma:
Direct spread into the orbit
Along the optic nerve into the cranial fossa
Subarachnoid space resulting in leptomeningeal metastases
Probable hematogenous to the bone
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