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Raccoon eye: An ocular presentation in metastatic neuroblastoma
Corresponding author: Dr. Aditya Kumar Gupta, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India. adivick@gmail.com
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Accepted: ,
How to cite this article: Kumar R, Prakash S, Gupta AK. Raccoon eye: An ocular presentation in metastatic neuroblastoma. Indian J Dermatol Venereol Leprol. doi: 10.25259/IJDVL_1378_2024
We report the case of a five-year-old girl who presented with progressive painful abdominal distension and bilateral periorbital ecchymosis, subconjunctival haemorrhage, and proptosis (left eye) for two weeks [Figure 1]. The swelling was soft with no limitation of ocular movements. Imaging (ultrasonography, computed tomography) showed a large left suprarenal mass. Bone marrow examination revealed infiltration by small round blue cells, clinching a diagnosis of metastatic neuroblastoma. Post-chemotherapy, there was a striking improvement in the ocular findings [Figure 2].
- Bilateral periorbital ecchymosis, swelling, subconjunctival haemorrhage and proptosis of left eye.
- Normal appearance of the eyes post-chemotherapy for neuroblastoma.
Orbital metastasis is seen in 10–20% of neuroblastoma cases, often presenting with a characteristic ‘raccoon eye’ appearance due to the presence of retrobulbar metastases. Proptosis in neuroblastoma is typically asymmetrical and soft, with a normal range of ocular movements, vis-à-vis leukemic ocular metastases (usually bilateral proptosis) and metastatic sarcoma (firm-to-hard and limited range of ocular movements).
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
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Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of AI-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
