Retinoblastoma presenting as haemorrhagic choroidal detachment in a 10-year-old girl

• Published in: BMJ case reports Vol. 2018; p. bcr-2018-226149
• Main Authors: Sosuan, George Michael Ngo, Eleazar-Verde, Jazel T, Mercado, Gary John V, Arroyo, Milagros H
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 24-10-2018; BMJ Publishing Group
• Series: Case Report
• Subjects: Cancer; Case reports; Cataracts; Child; Choroid Diseases - etiology; Choroid Hemorrhage - etiology; Epidemiology; Eye Enucleation; Eye Injuries - etiology; Eye surgery; Female; Glaucoma; Hemorrhage; Humans; Light; Medical imaging; Pain; Retina; Retinal Neoplasms - complications; Retinal Neoplasms - surgery; Retinoblastoma; Retinoblastoma - complications; Retinoblastoma - surgery; Tumors; Ultrasonic imaging; Unusual Association of Diseases/Symptoms; Vision Disorders - etiology; retina; glaucoma
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2018-226149

To report a case of retinoblastoma presenting as haemorrhagic choroidal detachment in a 10-year-old girl. The patient, apparently well, presented with sudden blurring of vision in the setting of blunt trauma. On examination and ocular ultrasound, haemorrhagic choroidal detachment was suspected. She underwent external drainage via sclerostomies. The haemorrhage resolved ultrasonographically, but the vision did not improve. Five months postoperatively, she presented with sudden eye pain, lid swelling and proptosis. The ancillary workups were consistent with panophthalmitis and was treated as such. Six months postoperatively, the pain and lid swelling persisted; hence, the painful near absolute eye was enucleated. The histopathology revealed small round blue cells with necrosis consistent with retinoblastoma. Immunohistochemistry was positive for synaptophysin and negative for S100 confirming retinoblastoma. Retinoblastoma is the most common intraocular malignancy in children. The importance of increased awareness of its various presentations is of utmost importance to prevent life-threatening and vision-impairing complications.