Retinoblastoma differential diagnosis: Difference between revisions
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Retinoblastoma | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Retinoblastoma<ref name="pmid11875173">{{cite journal |vauthors=Butros LJ, Abramson DH, Dunkel IJ |title=Delayed diagnosis of retinoblastoma: analysis of degree, cause, and potential consequences |journal=Pediatrics |volume=109 |issue=3 |pages=E45 |date=March 2002 |pmid=11875173 |doi= |url=}}</ref><ref name="pmid21680213">{{cite journal |vauthors=Sachdeva R, Schoenfield L, Marcotty A, Singh AD |title=Retinoblastoma with autoinfarction presenting as orbital cellulitis |journal=J AAPOS |volume=15 |issue=3 |pages=302–4 |date=June 2011 |pmid=21680213 |doi=10.1016/j.jaapos.2011.02.013 |url=}}</ref> | ||
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* | *[[Retinal]] [[mass]] | ||
*Physical exam reveals a whitish tumor with prominent vascularity | |||
*Vitrous seeding in endophytic tumors | |||
*exudative retinal detachment in exophytic tumor | |||
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* | *Sporadic in 90% of the cases | ||
*The median age of diagnosis is 18 months | |||
*Bilateral in 70% of the cases | |||
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* | *Presence of leukocoria | ||
*US imaging: | |||
**a dome or placoid-shaped intraocular mass | |||
**+/-intralesional calcifi cation | |||
*CT imaging: presence of calcification within the tumor | |||
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*Associated with 13q deletion syndrome | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Coats'disease (exudative retinitis or retinal telangiectasis) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Coats'disease (exudative retinitis or retinal telangiectasis) |
Revision as of 16:24, 7 May 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Retinoblastoma must be differentiated from other diseases that cause leukocoria such as congenital cataract, persistent fetal vasculature, Coats disease, coloboma of choroid or optic disc, toxocariasis, astrocytic hamartoma, retinopathy of prematurity, vitreous hemorrhage, uveitis, retinal dysplasia, and medulloepithelioma.[1]
Differential diagnosis
Retinoblastoma must be differentiated from other diseases that cause leukocoria. The common causes of leukocoria in children include:[1]
- Congenital cataract
- Persistent fetal vasculature
- Coats disease
Less common causes of leukocoria include:
- Coloboma of choroid or optic disc
- Toxocariasis
- Astrocytic hamartoma
- Retinopathy of prematurity (stage 4, 5)
- Vitreous hemorrhage
- Uveitis
- Retinal dysplasia
- Medulloepithelioma
Differential diagnosis of leukocoria
Disease/Condition | Clinical presentation | Demographics/History | Diagnosis | Other notes |
---|---|---|---|---|
Retinoblastoma[2][3] |
|
|
| |
Coats'disease (exudative retinitis or retinal telangiectasis) |
|
|
| |
PHPV/Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) |
|
|
| |
Astrocytic hamartoma |
|
|
| |
Retinopathy of prematurity (ROP) |
|
|
| |
Ocular toxocariasis |
|
|
|
|
Hereditary retinal syndrome |
|
|
|
Differentiating features of some common and less common differential diagnosis are:
Disease/Condition | Age of presentation | Risk factors | Unilateral/bilateral | Differentiating Signs/Symptoms | Axial length | Imaging findings |
---|---|---|---|---|---|---|
Retinoblastoma |
|
|
|
|
|
|
Congenital Cataract |
|
| ||||
Coats disease (exudative retinitis or retinal telangiectasis) |
|
| ||||
Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) |
|
| ||||
Retinopathy of prematurity (ROP) |
|
| ||||
Ocular toxocariasis |
|
|
Disease | Prominent clinical feature | Radiological findings |
---|---|---|
Ocular cysticercosis |
|
|
Retinal detachment |
|
|
Hyperthyroid Ophthalmopathy |
|
|
Retinoblastoma |
|
|
References
- ↑ 1.0 1.1 Retinoblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Retinoblastoma#cite_note-30 Accessed on October 2, 2015
- ↑ Butros LJ, Abramson DH, Dunkel IJ (March 2002). "Delayed diagnosis of retinoblastoma: analysis of degree, cause, and potential consequences". Pediatrics. 109 (3): E45. PMID 11875173.
- ↑ Sachdeva R, Schoenfield L, Marcotty A, Singh AD (June 2011). "Retinoblastoma with autoinfarction presenting as orbital cellulitis". J AAPOS. 15 (3): 302–4. doi:10.1016/j.jaapos.2011.02.013. PMID 21680213.
- ↑ 4.0 4.1 "How to Diagnose and Manage Coats' Disease".
- ↑ 5.0 5.1 "Management of retinal detachment: a guide for non-ophthalmologists".
- ↑ 6.0 6.1 "Thyroid Ophthalmopathy - EyeWiki".
- ↑ 7.0 7.1 "c.ymcdn.com".