Case Study: December 2011
- 5 year old male child
- Left non-axial proptosis developed over 2 months
- Biopsy performed of orbital mass
- See figures 1 and 2
- What do Figures 1 and 2 show? What is the differential diagnosis?
- The tumour was strongly positive for CD56, chromogranin, synaptophysin, PGP9.5 and for NSE. What are the likeliest diagnoses now?
- What could you suggest to the ophthalmologists?
Click to show answers
- Packeted small round blue cell tumour. Differential is : rhabdomyosarcoma, extraocular retinoblastoma, neuroblastoma (olfactory v metastatic), Wilm’s, Ewing’s, PNET.
- Olfactory v metastatic neuroblastoma. Olfactory would be unusual in a child though.
- Abdominal imaging. In this case, the child had a left suprarenal mass. The diagnosis was therefore one of orbital metastatic neuroblastoma.