Raccoon eyes (also known in the United Kingdom and Ireland as panda eyes) or periorbital ecchymosis is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain cancers. Gumus K. Moran DE(1), Donoghue V. Author information: (1)Department of Radiology, Children's University Hospital, Temple Street, Dublin 1, Ireland. Neuroblastoma with orbital metastasis: ophthalmic presentation and role of ophthalmologists. Eye 2006; 20:466-70. Periorbital ecchymosis or raccoon eye or panda sign is commonly seen in surgical emergency and results from accidental injuries to the base of the skull. Neuroblastoma is an undifferentiated malignant tumor that commonly occurs in children, which can rapidly metastasize and widely spread, resulting in a variety of clinical manifestations, such as proptosis, periorbital ecchymosis, abdominal pain, anemia, pancytopenia, bone pain, and paralysis. One child died during treatment. Average duration of follow-up was 19.5 months (range 2-58 months). Two have completed treatment and are under follow-up. Periorbital ecchymosis ('raccoon eyes') as the presenting feature of neuroblastoma. Pediatr Radiol 2010; 40: 1710. Figure 28-29 Bilateral orbital metastasis from neuroblastoma in a 2-year-old girl, presenting with periorbital ecchymosis. On physical examination, she was noted to have periorbital ecchymosis, dysconjugate gaze, dilated and fixed pupils, and an abdominal mass. Neuroblastoma is predominantly a tumour of early childhood, which metastasises to the orbits. These include bone pain due to widespread bone metastases, periorbital ecchymosis and proptosis due to retrobulbar metastasis, and abdominal distention and respiratory problems due to liver metastases, especially in infants. ... the International Neuroblastoma Risk Group considers chromosome 11q aberrations in the evaluation. Presenting features of the six children were proptosis in four, periorbital ecchymosis in two, ocular motility restriction in two, and subconjunctival haemorrhage in one. deirdre.moran@st-vincents.ie Figure 28-30 Right Horner syndrome, the presenting sign of localized intrathoracic neuroblastoma in a 6-month-old boy. Moran DE, Donoughe V. Periorbital ecchymosis ('raccoon eyes') as the presenting feature of neuroblastoma. Ahmed S, Goel S, Khandwala M, Agrawal A, Simmons IG. Metastatic neuroblastoma (secondary to tumoral obstruction of the palpebral vessels): neuroblastoma can present as periorbital ecchymosis in 5.4% of cases; Orbital metastasis of solid malignancies; Kaposi sarcoma View Media Gallery Most neuroblastomas produce catecholamines as metabolic by-products, which result in some of the most interesting presentations observed in children with neuroblastoma. Examination of an open-biopsy specimen of the abdominal mass revealed neuroblastoma. A nine-month-old girl was seen for failure to thrive and bruising around the eyes. Raccoon eyes is most often caused by a basal skull fracture (BSF).The basal part of your skull is the bottom portion where the brain rests. When a … Examination of an open-biopsy specimen of the abdominal mass revealed neuroblastoma. Upper periorbital edema, proptosis, and ocular ecchymosis in a 9-month-old girl.

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