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Orbital Metastatic Neuroblastoma — RACP Paediatrics MCQ

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ModerateHaematology & OncologyOrbital Metastatic NeuroblastomaRACP Paediatrics

A 3-year-old presents with unilateral painless proptosis and periorbital ecchymosis ('raccoon eyes'). CT shows an orbital mass extending from the sphenoid. Urine catecholamines are elevated. What is the most likely diagnosis?

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Correct answer: D — Metastatic neuroblastoma

Periorbital ecchymosis (raccoon eyes) with proptosis and elevated urine catecholamines is classic for metastatic neuroblastoma to the orbit. Primary neuroblastoma typically arises from the adrenal gland or sympathetic chain. MIBG scan and bone marrow biopsy are required for staging.

Reference: ANZCHOG – 2024 – Treatment Guidelines: Neuroblastoma