Ultrasonographic Aid in the Diagnosis of Retinoblastoma-Suspected Cases

We recently examined two cases of leucocoria which posed a difficult differential diagnosis problem. The first case, Manuela B, a 2.5 year old girl was referred because of an extensive retinal detachment in the temporal region of the left eye. The retina had a yellowish colour and some small minor vascular anomalies could be seen at the edge of the lesion. Ultrasound examination demonstrated a retinal detachment echo in the temporal (4.0 μs) and inferior region (6.0 μs) (Figure 1). This echo was followed by a 2.0 μs broad complex with a high reflectivity (50–85%), a rather irregular structure and low absorption. A repeat examination two months later showed a more elevated retinal detachment (8 μs). Neither ultrasound nor fluorography could exclude the possibility of a tumour mass and CT examination remained negative. Enucleation was performed because of blindness of the eye and enlargement of the detachment. Histology showed an exudative retinopathy (Coat’s disease) with a subretinal mass composed of fibrous tissue, cholesterol, macrophages, giant cells and a large amount of calcification.