Abstract
A 10-month-old boy was observed for 2 months’ history of recurrent bruising around the eyes. His parents denied any history of trauma. On ophthalmic examination, bilateral periorbital ecchymosis (raccoon eyes) and subconjunctival hemorrhages were noted (Fig A). Computed tomography shows bilateral extensive mass surrounding bony orbit with widespread skull bone erosion (Fig B). Positron emission tomography-computed tomography revealed a large mass within the left adrenal gland region (Fig C). A biopsy of the abdominal mass and histopathology revealed small round blue cell tumor with background neuropil (Fig D, 40×, arrow).
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