Enucleation for retinoblastoma in a 22-month-old boy

Retinoblastoma is the commonest intraocular tumor in childhood. Management of retinoblastoma is quite complex depending on the stage, visual and globe saving, psychosocial factors, modality of treatment, and health infrastructure. We report a case of retinoblastoma in a child in a limited health facility without a pediatric oncologist or ophthalmology oncologist. A 22-month old boy came with complaints of leukocoria which his parents had known since the previous week. Ultrasonography of the eye shows calcification on the retina that supports Group E retinoblastoma. Bone marrow aspiration and MRI cannot be performed due to limited resources. Even though the parents only noticed the symptoms for a week and immediately brought to the ophthalmologist, the retinoblastoma stage was already in Group E. Enucleation and globe salvage were unavoidable. Enucleation was performed on the patient with histopathology finding the presence of Flexner-Wintersteiner rosette cells. After enucleation, he was referred to the oncologist for adjuvant chemotherapy. Early retinoblastoma detection is crucial in increasing the cure rate while maintaining children's vision.