Tubercular endophthalmitis simulating retinoblastoma.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Pediatric Oncology

Background:

• Retinoblastoma is the most common primary intraocular malignancy in children.
• Leukocoria (white pupillary reflex) is a common presenting sign of retinoblastoma.
• Other conditions can mimic retinoblastoma, necessitating a broad differential diagnosis.

Observation:

• An 8-year-old female presented with leukocoria and vision loss in the left eye.
• Clinical and imaging studies, including CT scan, revealed a vitreous mass with calcifications, raising suspicion for retinoblastoma.
• Histopathological examination of the enucleated eye confirmed chronic granulomatous endophthalmitis with acid-fast bacilli.

Findings:

• The histopathology was consistent with ocular tuberculosis.
• The case highlights the potential for tubercular endophthalmitis to present with features indistinguishable from retinoblastoma.
• Calcifications within the vitreous mass were a key finding.

Implications:

• This case underscores the importance of considering infectious etiologies, particularly tuberculosis, in the differential diagnosis of pediatric leukocoria.
• Accurate diagnosis is critical to avoid unnecessary enucleation and to initiate appropriate anti-tubercular therapy.
• Further research into differentiating features may improve early diagnosis and management.