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一例伪装成眼内炎的视网膜母细胞瘤:不寻常的表现及临床病理相关性

A case of retinoblastoma masquerading as endophthalmitis: Unusual presentation and clinicopathological correlation.

作者信息

AlQahtani Ghadah M S, Alkatan Hind M, AlMesfer Saleh, Elkhamary Sahar, Maktabi Azza M Y

机构信息

Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Departments of Ophthalmology and Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110263. doi: 10.1016/j.ijscr.2024.110263. Epub 2024 Sep 10.

Abstract

INTRODUCTION

Retinoblastoma is a serious childhood intraocular neoplasm that can be diagnosed clinically with the aid of B-scan ultrasound, and radiological examination. On the other hand, the differential diagnosis includes benign and other masquerading conditions such as uveitis and endophthalmitis thus adding challenge to the proper diagnosis.

PRESENTATION OF CASE

A six-year-old girl presented with leukocoria and decreased vision of the right eye. Patient was diagnosed and treated as a case of endophthalmitis elsewherewith no improvement. She was re-evaluated in our hospital and found to have cataract with ruptured capsule, and no view to the fundus. B scan was conducted and showed posterior cavity mass with calcification, and retinal detachment. Retinoblastoma was suspected and proved by examination under anesthesia. Enucleation was carried out and the diagnosis was further confirmed by histopathological examination.

DISCUSSION

Diagnosis of retinoblastoma can be challenging since leukocoria is the most common presenting complaint, which can be also seen in other benign conditions such as Coat's disease. It may also masquerade as endophthalmitis, uveitis with or without glaucoma, and retinal detachment. High suspicious of retinoblastoma in children and appropriate examination and work up with the aid of Biomicroscopy and radiological examination will help reaching the appropriate diagnosis saving patients unnecessary interventions with related morbidity.

CONCLUSION

Retinoblastoma has a wide spectrum of clinical presentations and must be ruled out before performing any intraocular procedure.

摘要

引言

视网膜母细胞瘤是一种严重的儿童眼内肿瘤,可借助B超超声及放射学检查进行临床诊断。另一方面,鉴别诊断包括良性及其他伪装病症,如葡萄膜炎和眼内炎,这给准确诊断带来了挑战。

病例介绍

一名6岁女孩因右眼白瞳症和视力下降就诊。该患者在其他地方被诊断为眼内炎并接受治疗,但病情无改善。她在我院重新接受评估,发现有晶状体囊破裂的白内障,无法看清眼底。进行了B超检查,显示后房有钙化肿块及视网膜脱离。怀疑为视网膜母细胞瘤,经麻醉下检查得以证实。实施了眼球摘除术,组织病理学检查进一步证实了诊断。

讨论

视网膜母细胞瘤的诊断具有挑战性,因为白瞳症是最常见的就诊主诉,在其他良性病症如科茨病中也可见到。它还可能伪装成眼内炎、伴有或不伴有青光眼的葡萄膜炎以及视网膜脱离。对儿童高度怀疑视网膜母细胞瘤,并借助生物显微镜检查和放射学检查进行适当的检查和评估,将有助于做出准确诊断,避免患者进行不必要的干预及相关并发症。

结论

视网膜母细胞瘤有广泛的临床表现,在进行任何眼内手术前必须排除该疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e77/11424937/5b4d86ea922d/ga1.jpg

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