title: Isolated enophthalmos: an uncommon gateway to orbital tumors in pediatrics: 9 month-old female presenting with isolated enophthalmos as the unique sign of a metastatic orbital tumor: a case report.
abstract: BACKGROUND
  If extra-axial proptosis is by far the most common symptom of infantile malignant orbital tumors, enophthalmos is a rare and undocumented sign. We report the first case of a pediatric metastatic orbital tumor revealed by enophthalmos alone.
  
  
  METHODS
  A 9-month-old girl was diagnosed with isolated right-sided enophthalmos. An orbital tumor was suspected and computed tomography undertaken showing osteolysis and periosteal reaction of orbital walls, malar bones and zygomatic arches. A Thoracic- abdominal CT scan confirmed a stage-4 neuroblastoma.
  
  
  CONCLUSIONS
  Enophthalmos can be the sole symptom of an orbital tumor and should lead to immediate imaging assessment. This association is not well known in pediatrics but is relevant to insure the best prognosis.
authors.affiliation: Ophthalmology Department, La Pitié Salpétrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France. saratouhami@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Touhami
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bui-Quoc
mesh_terms: D015841:Enophthalmos / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D009447:Neuroblastoma / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary*; D009918:Orbital Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary*; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed