[Periorbital ecchymosis--trauma or tumor?]

Area of Science:

• Pediatric Oncology
• Medical Case Reports

Background:

• Neuroblastoma is a significant pediatric malignancy, ranking as the second most common solid tumor in infancy.
• The non-specific clinical presentation of neuroblastoma often delays diagnosis.

Observation:

• An 11-month-old patient presented with progressive supraorbital swelling, periorbital ecchymosis, hepatosplenomegaly, and B-symptoms.
• The characteristic "raccoon eyes" sign was observed, indicative of osseous metastasis to the orbits and skull.

Findings:

• Diagnosis of neuroblastoma was confirmed through comprehensive clinical evaluation, physical examination, laboratory tests, and imaging.
• Periorbital swelling, a key symptom, can be misdiagnosed as non-accidental trauma in pediatric patients.

Implications:

• Early recognition of subtle signs like "raccoon eyes" is crucial for timely neuroblastoma diagnosis.
• Prognosis is influenced by factors such as tumor stage, biology, and patient age, underscoring the need for individualized treatment strategies.