Late-onset retinoblastoma camouflaged with proven chronic uveitis: A case report

Abstract

A rare case of a 16year old female, diagnosed elsewhere as chronic uveitis in the left eye positive antinuclear antibodies and Anti-SSA antibodies, treated with steroids and referred for cyclocryotherapy for a painful blind eye. On examination, the patient denied perception of light. There was proptosis, limitation of extraocular movements and corneal melting with no view of the posterior segment. Ultrasound B scan showed dense vitritis with doubtful specks of calcification. Magnetic resonance imaging revealed a soft tissue mass obliterating the vitreous and anterior chamber with retroscleral extension and involvement of the optic nerve. Extended enucleation was performed under General anaesthesia. Histopathological examination confirmed a well differentiated retinoblastoma with extrascleral and optic nerve involvement. Metastatic work up was normal. Intravenous Chemotherapy and post surgery radiotherapy to the socket was advised for further management. Late onset retinoblastoma mimicking ocular inflammation with positive antibody serology is rare and the report shows the need for imaging in refractory uveitis.