History of Lukocoria and loss of vision
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The right eyeball is shrunken with loss of internal organization. There is intraocular bleed/ calcifications seen as blooming in SWAN. The extra-ocular muscles reveal enhancement on postcontrast study. The thickened right optic nerve is continuous with a large extra-axial lobulated suprasellar-basifrontal mass which is inseparable from the optic chiasma, hypothalamus and is seen to encase the right ICA & its divisions. There is mass effect but little edema. There is subacute/chronic blood products in the mass. Postcontrast study reveals intense and heterogeneous enhancement with extensive leptomeningeal metastasis and sulcal deposits & enhancement in the surface of cerebral hemispheres & in cerebellar vermian foliae.
Left eyeball is within normal limits.
This case is of direct spread of retinoblastoma of right eye into the optic nerve & into the skull base as a large extra-axial mass with extensive leptomeningeal metastases - Stage IV.
- A A K A Razek and S Elkhamary, MRI of retinoblastoma. Br J Radiol. 2011 Sep; 84(1005): 775–784. doi: 10.1259/bjr/32022497