1. MedPix Medical Image Database COW - Case of the Week Case Contributor: Timothy J Biega Affiliation: Uniformed Services University

2. MedPix No: 5846 - History Pt Demographics: Age = 4 y.o. Gender = girl A 4 year old girl with history of decreased vision and *white eye* since age two. She had no other significant medical history. Downloaded by (-1)

3. MedPix No: 5846 - EXAM & LABS Screening physical exam demonstrated lack of red reflex on the left eye (leukokoria) but was otherwise unremarkable.Screening labs demonstrated a normocytic anemia, but was otherwise unremarkable.

4. Retinoblastoma Axial non-contrast CT scan demonstrates a calcifed mass extending from the left retina. Downloaded by (-1)

5. Retinoblastoma Axial non-contrast CT scan demonstrates a calcifed mass extending from the left retina. Downloaded by (-1)

6. FINDINGS A non-contrast head CT was performed and demonstrated a calcified mass throughout the left globe without extension outside the globe.The MRI obtained post-operatively (not shown) demonstrated no intracranial extension.

7. DIFFERENTIAL DIAGNOSIS What is your Differential Diagnosis? 1. Coats disease, a degenerative proliferation of the retina - 2. Persistent hyperplastic primary vitreous - 3. Calcified retinal hamartoma of tuberous sclerosis -

8. Diagnosis: Retinoblastoma Dx Confirmed by:

9. DISCUSSION Further discussion, see: Barkovich JA. Pediatric Neuroimaging. 3rd ed. Philadelphia; Lippincott Williams and Wilkins. 2000. pp 546-549.