Retinoblastoma differential diagnosis: Difference between revisions
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*[[Retinal]] [[mass]] | *[[Retinal]] [[mass]] | ||
*[[Physical exam]] reveals a whitish [[tumor]] with prominent [[Vascular|vascularity]] | *[[Physical exam]](P/E) reveals a whitish [[tumor]] with prominent [[Vascular|vascularity]] | ||
*[[Vitreous]] seeding in endophytic [[tumors]] | *[[Vitreous]] seeding in endophytic [[tumors]] | ||
*[[exudative]] [[retinal detachment]] in exophytic [[tumor]] | *[[exudative]] [[retinal detachment]] in exophytic [[tumor]] | ||
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*Associated with [[13q deletion syndrome]] | *Associated with [[13q deletion syndrome]] | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Coats'disease | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Coats'disease | ||
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* | * Yellowish appearance of leukocoria | ||
*P/E:exudative retinal detachment with vascular tortuosity and telangiectasia | |||
*+/- neurovascular glaucoma | |||
*Absence of calcification | |||
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* | *Sporadic in 100% of the cases | ||
*Almost always unilateral | |||
*More common among boys | |||
*The median age of diagnosis 5 to 9 years | |||
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*P/E is diagnostic in most of the cases | |||
*Ultrasound examination: | |||
**Complete retinal detachment | |||
**Absence of calcification | |||
**Exudative, mobile lipid material under retina | |||
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* | *Fluorescein angiographyr reveals characteristic telangiectasias of small to medium-sized retinal vessels | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | PHPV/Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | PHPV/Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 17:58, 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 |
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Retinoblastoma[2][3] |
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Coats'disease |
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PHPV/Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) |
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Astrocytic hamartoma |
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Retinopathy of prematurity (ROP) |
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Ocular toxocariasis |
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Hereditary retinal syndrome |
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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 |
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Congenital Cataract |
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Coats disease (exudative retinitis or retinal telangiectasis) |
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Persistent fetal vasculature (formerly known as persistent hyperplastic primary vitreous) |
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Retinopathy of prematurity (ROP) |
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Ocular toxocariasis |
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Disease | Prominent clinical feature | Radiological findings |
---|---|---|
Ocular cysticercosis |
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Retinal detachment |
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Hyperthyroid Ophthalmopathy |
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Retinoblastoma |
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|
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".