Orbital Fibrosis and Intraocular Recurrence of Retinoblastoma Following Periocular Carboplatin

A 5-month-old infant with bilateral advanced retinoblastoma underwent six cycles of systemic chemotherapy. In an attempt to salvage the second eye, three serial injections of periocular carboplatin were given for persistent vitreous seeding. Following the third injection, the patient developed periocular ecchymosis and magnetic resonance imaging demonstrated abnormal signal characteristics at the site of injection. An orbital biopsy did not demonstrate extraocular tumor extension, but histopathologic examination revealed severe orbital fibrosis and fat necrosis. Following the biopsy, the patient developed an intraocular tumor recurrence at the same location where the carboplatin injections had been given and enucleation was performed to prevent tumor spread. In this case, a child developed orbital scarring and intraocular tumor recurrence at the site of injection following treatment with periocular carboplatin.