title: Retinoblastoma presenting with orbital cellulitis.
abstract: OBJECTIVE
  To study the effectiveness of pre-enucleation steroids in reducing inflammation in patients with retinoblastoma presenting as orbital cellulitis.
  
  
  METHODS
  Medical records of consecutive retinoblastoma patients presenting at a single tertiary eye care center during a period of 3 years were retrospectively reviewed. For those who presented with orbital cellulitis, clinical, radiological, and histopathological variables were assessed. The effect of pre-enucleation steroids was noted in this group of patients.
  
  
  RESULTS
  Of 260 retinoblastoma cases reviewed, 14 had retinoblastoma-associated cellulitis (5.39%). Of these 14 patients, 4 received neoadjuvant chemotherapy and were excluded from the series. Of the remaining 10 cases (mean age at presentation, 14.2 months; mean follow-up, 16.4 months), 9 presented with orbital cellulitis and were included in the study. Radiological imaging depicted intraocular tumors occupying 80% to 100% of the globe in each case. All patients underwent enucleation. Five children received pre-enucleation systemic steroids (mean, 5.4 days), which resulted in a prompt decrease in inflammation. Postenucleation chemotherapy was administered in 4 (6 cycles) and external beam radiation therapy in 1 patient with high-risk histopathological characteristics.
  
  
  CONCLUSIONS
  Advanced necrotic retinoblastoma with anterior segment involvement may present as orbital cellulitis. Pre-enucleation systemic steroids can aid in the surgical management of these tumors.
authors.affiliation: Department of Vitreo-Retinal Services, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India.
authors.forename: Jaydeep
authors.initials: J
authors.lastname: Walinjkar
authors.forename: S
authors.initials: S
authors.lastname: Krishnakumar
authors.forename: Lingam
authors.initials: L
authors.lastname: Gopal
authors.forename: Anita
authors.initials: A
authors.lastname: Ramesh
authors.forename: Vikas
authors.initials: V
authors.lastname: Khetan
mesh_terms: D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D015353:Eye Enucleation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D054517:Orbital Cellulitis / Q000175:diagnosis* / Q000628:therapy; D011882:Radiotherapy, High-Energy; D019572:Retinal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D012175:Retinoblastoma / Q000175:diagnosis* / Q000628:therapy