Recurrent bruising of lower eyelids: a presenting symptom of neuroblastoma in a child/Alt gozkapaklarinda tekrarlayan morluklar yakinmasiyla basvuran noroblastomlu bir cocuk olgu.
It is well known that periorbital ecchymosis is easily recognized and associated with basal skull fractures. In cases without a history of trauma it may be a sign of systemic abnormalities such as neuroblastoma . Particularly in mild cases, the correct diagnosis of this condition is sometimes delayed because of workup for other conditions such as child abuse and hematological coagulopathies. In this case, recurrent bruising of lower eyelids had been previously thought the result from disorders of coagulation.
The characteristic "raccoon eyes" appearance associated with neuroblastoma is probably related to obstruction of the palpebral vessels by tumor tissue in and around the orbits . Interestingly, there was no typical raccoon eyes appearance and metastatic involvement of the periorbital tissue on MRI in our case.
Written consent for publication of the photo from the parents was obtained.
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[1.] Bay A, Faik Oner A. Raccoon eyes. Indian Pediatr. 2005;42:949.
[2.] Timmerman R. Images in clinical medicine. Raccoon eyes and neuroblastoma. N Engl J Med.2003;349:e4.
Mustafa Buyukavci, Zuhal Keskin Yildirim
Ataturk University, Faculty of Medicine, Division of Pediatric Oncology, Erzurum, Turkey
Address for Correspondence: Assoc. Prof. Mustafa Buyukavci, Arastirma Hastanesi Cocuk Servisi 25240 Erzurum, Turkey Phone: +90 442 231 68 91 E-mail: email@example.com
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|Title Annotation:||Images in Hematology|
|Author:||Buyukavci, Mustafa; Yildirim, Zuhal Keskin|
|Publication:||Turkish Journal of Hematology|
|Article Type:||Clinical report|
|Date:||Dec 1, 2009|
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