Bilateral Metastatic Orbital Neuroblastoma in an Adult

Neuroblastoma is the most common extra cranial solid malignancy in children but it is rare in adults. We report a 35 year old woman who presented with bilateral proptosis with visual loss, fever, and bone pain and weight loss. Computed tomography showed orbital adrenal mass with bony lesions of orbit and calvarium. CT abdomen revealed a pelvic mass which was suspected to be the primary. There were metastatic deposits at distant sites suggesting a diffuse infiltrative malignancy. Urine catecholamines were normal. MIBG scan was negative. Histopathology showed “small dark round cell tumor” and immuno histo chemistry confirmed the diagnosis of neuroblastoma. The patient was subjected to chemotherapy based on paediatric protocols for neuroblastoma and she is clinically stable till date. Neuroblastoma should be considered in the differential diagnosis of bilateral orbital tumor in an adult. Urine catecholamine levels may be normal in adult neuroblastoma.