Bilateral Metastatic Orbital Neuroblastoma with Unusual Clinico-radiologic Manifestation

Neuroblastoma like most primitive neoplasm, primarily affects children under five years. It is uncommon in adolescents and adults. We present a 13-year-old male adolescent with a three-month history of bilateral painful progressive proptosis associated with gradual loss of vision. A contrast-enhanced Computed Tomography scan of the chest and abdomen showed an unusually symmetrical bilateral paravertebral soft tissue masses extending from the cervical to the lumbosacral spines, seamlessly merging with the psoas muscle. A tissue biopsy from the orbital mass reported neuroblastoma. He improved significantly three months following chemotherapy and has been stable during follow up. This case report seeks to demonstrate the many variations in the clinico-radiologic presentation of neuroblastoma and the need for a multidisciplinary approach to patient care, especially in resource-poor setting to ensure good outcome.