An 18-month-old child presents with white pupillary reflex noted by the mother in photographs. Examination shows strabismus. CT scan reveals a calcified intraocular mass filling the vitreous cavity.

• A Congenital cataract
• B Retinoblastoma ✓
• C Coats disease
• D Persistent hyperplastic primary vitreous

Explanation

Leukocoria with a calcified intraocular mass in a child under 3 years is retinoblastoma until proven otherwise. Calcification within the tumor is a characteristic imaging feature and helps separate it from mimics. Congenital cataract and persistent hyperplastic primary vitreous present early in infancy without a calcified mass. Coats disease shows retinal telangiectasia with exudation and typically affects older boys without intravitreal calcification. Retinoblastoma arises from biallelic RB1 gene inactivation, inherited in about 40 percent of cases.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.