August 1996

Radiological Case of the Month

Author Affiliations

From the Departments of Radiology and Ophthalmology, Childrens Hospital Los Angeles, University of Southern California School of Medicine, Los Angeles.

Arch Pediatr Adolesc Med. 1996;150(8):873-874. doi:10.1001/archpedi.1996.02170330099017

AN 18-MONTH-OLD child presented to the emergency department with a 5-day history of right orbital cellulitis (Figure 1) and tugging on the pinna of the right ear. By physical examination the child's temperature was 38°C, the right eyelid and conjunctivae were swollen and protuberant, and there was otitis media.

The child's pupils were not dilated, and the fundi were not well seen owing to the patient's eye movements. The patient had been seen at another hospital 3 days before and was treated with oral antibiotics for orbital cellulitis; however, the swelling of the right eye continued and the child was admitted for intravenous antibiotic treatment. Consultation with an ophthalmologist was obtained followed by a computed tomographic scan of the orbits (Figure 2).

Denouement and Discussion 

Retinoblastoma Presenting With Orbital Cellulitis  Retinoblastoma is the most common intraocular malignancy of childhood. Although the initial symptoms are variable, a majority of patients (60%)

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