[Periorbital ecchymosis--trauma or tumor?]

We report about an 11 month old patient, who presented with progressive supraorbital swelling, periorbital ecchymosis, hepatosplenomegalia and B-symptoms. Neuroblastoma was subsequently diagnosed based on the clinical history, physical examination, laboratory tests and imaging findings. Neuroblastoma is the second most frequent solid tumor in infancy. Clinical symptoms are not specific. The so called "raccoon eyes", as seen in our patient, result from osseous metastasis to the orbits and skull. Periorbital swelling may initially be misinterpreted as child abuse. Prognosis of neuroblastoma depends on various factors including initial tumor staging, tumor biology and the child's age.