Patient History
2-year-old with left leukocoria.
Findings
Contrast-enhanced CT was performed from the skull base to the thoracic inlet. The study demonstrates a large calcified left intra-ocular mass which is slightly enlarging the left globe. The mass has both a soft tissue and calcified component. The left lens is not visualized and may be eroded by the intra-ocular mass.
There is diffuse enlargement of the left optic nerve extending posteriorly through the left superior orbital fissure and optic canal. There is enlargement of the orbital apex, left superior orbital fissure and left optic canal indicative of a longstanding process. The coronal images demonstrate lateral displacement of the supraclinoid carotid artery suggestive of a sellar/suprasellar mass and can be further evaluated with contrast-enhanced MRI of the brain.
No evidence of enlarged lymph nodes are identified. The right globe appears to be within normal limits without evidence of calcified intra-ocular mass.
Visualized portion of the lungs is grossly within normal limits. However, dedicated chest CT is necessary for complete diagnostic evaluation.
Conclusions
1. Large calcified intra-ocular mass consistent with retinoblastoma.
2. Diffuse enlargement of the left optic nerve likely due to retrobulbar involvement with extension along the left optic nerve.
3. Findings suggestive of a sellar/suprasellar mass which may represent intracranial extension/metastases.
