English

Abstract

Neuroblastoma is a childhood malignancy derived from the primordial neural crest cells that form the sympathetic nervous system. These tumours are notorious for their early tendency of metastasis. Symptoms arising from these such as proptosis can be the only manifestation of metastatic neuroblastoma (1). Early investigation is important, as metastatic disease requires aggressive management. We present a case of a 6 year old girl initially presenting with proptosis. INTRODUCTION: Virchow originally described Neuroblastoma in 1863. By the beginning of the 20 th century, its origin in sympathetic tissue was determined by Zuckerkandl and Kohn. It is the third most common pediatric malignancy, after leukaemia and central nervous system tumours (2). The median age at diagnosis is 22 months, and more than 95% cases are diagnosed by the age of 10 years. Approximately 1% of the patients present initially evidence of metastatic disease without a readily identifiable primary lesion. Neuroblastoma commonly metathesizes to bone (60%), regional lymph nodes (45%), orbits (20%), liver (15%), intracranial (14%) and lung (10%)(2). CASE REPORT: A 6 year old girl presented with the complaint of progressively increasing proptosis of bilateral eyes. The girl underwent contrast enhanced CT Scan of brain and orbits which revealed: 1. Bilateral enhancing retro-orbital masses. 2. Enhancing soft tissue masses overlying the bilateral parietal bones. 3. Separation of the coronal sutures. 4. Enhancing extra axial intracranial soft tissue mass suggestive of dural metastasis.