A Case Of Misdiagnosed Diffuse Infiltrating Retinoblastoma

PurposeThe aim of this case report is to describe a case of a 19 months old female with diffuse infiltrating retinoblastoma in her right eye misdiagnosed as corneal dystrophy in another center. Diffuse infiltrating retinoblastoma can lead to anterior segment seeding with pseudohypopion, pseudoialitis and parsplanitis, intraocular hemorrhage confusing it with uveitis, unexplained vitreous hemorrhage, hyphema or endophalmitis.MethodsIn October 2016 the girl was observed at our Ocular Oncology Unit at the University of Siena. At ophthalmoscopic examination in her right eye she presented hyperemia, corneal edema, endothelium alterations, flocculi in the angle, iris neovascularization, and hematic clots (3–10 h). At fundus examination there were not retinal masses, but cloudy vitreous and vitreous deposits inferiorly. The left eye was normal. B scan echography documented thickened retina and vitreous deposits. RMI excluded extraocular disease.ResultsThe eye was enucleated and the diagnosis of diffuse infiltrating retinoblastoma was confirmed.ConclusionsDiffuse infiltrating is the least common growth pattern of retinoblastoma and often the most difficult to recognize clinically. It grows diffusely within the retina .Any child with signs of uveitis, hyphema, hypopion, vitreous hemorrhage and ialitis should be evaluated for retinoblastoma.