case_images: PMC11250386_01
case_images: RetCam fundus photography of the right eye. There are scattered dense white vitreous opacities throughout the vitreous cavity. The retina is detached with prominent corrugations and maintains a dusky appearance. There is a prominent juxtapapillary retinal hemorrhage abutting the nasal aspect of the optic disc. A white exophytic retinal tumor emanates from the superior nasal quadrant. Findings are consistent with retinoblastoma with concomitant CMV retinitis.
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case_images: PMC11250386_01_cop-2024-0015-0001-538738_F01.jpg
case_images: F1
case_images: It also revealed an exudative retinal detachment with subretinal seeding inferiorly, as well as a 6-mm x 6-mm tumor in the superonasal quadrant of the right eye (Fig. 1).
case_images: B-Scan of the right eye. a, b B-scan ultrasound of the right eye confirmed dense vitreous seeds along with a retinal mass emanating from the superonasal quadrant. There was no evidence of extrascleral extension. A low-lying exudative retinal detachment is also noted. There is no evidence of optic nerve compromise. Red arrow: retinoblastoma; white arrowhead: dense vitreous seeds; white dashed arrow: retinal detachment.
case_images: cop-2024-0015-0001-538738_F02.jpg
case_images: PMC11250386_01_cop-2024-0015-0001-538738_F02.jpg
case_images: F2
case_images: B-scan ultrasound of the right eye confirmed dense vitreous seeding, a hyperechogenic mass in the superonasal quadrant, and a low-lying exudative retinal detachment (Fig. 2).
case_images: MRI of the orbit with and without contrast. a Sagittal T1-weighted. b Axial contrast enhanced T1-weighted. c Axial non-contrast T1-weighted. d Axial T2 without manipulation. Demonstration of a retinal detachment along with a nodular 3 mm enhancing focus along the nasal aspect of the globe in the right eye. It emanates from the expected position of the ora serrata and appears consistent with retinoblastoma. Red arrow: retinoblastoma; white arrowhead: exudative retinal detachment.
case_images: cop-2024-0015-0001-538738_F03.jpg
case_images: PMC11250386_01_cop-2024-0015-0001-538738_F03.jpg
case_images: F3
case_images: A clinical diagnosis of unilateral right-sided group D retinoblastoma was made, and an MRI of the brain and orbit with and without contrast (Fig. 3) was consistent with the diagnosis and without evidence of trilateral disease.
case_images: Histopathologic findings of cytomegalovirus retinitis. Magnocellular, pleomorphic cells with granular, eosinophilic cytoplasmic inclusions and smudgy, intensely basophilic nuclear inclusions in a turbulent background of karyorrhexis and neutrophils were observed (a, x100; b, x400; c, x600). Immunohistochemistry for cytomegalovirus shows intense positivity (d).
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case_images: F4
case_images: Interestingly, histopathology from the enucleated eye was positive for CMV retinitis in addition to retinoblastoma (Fig. 4).