Orbital relapse of retinoblastoma in patients with high-risk histopathology features

AIM: To describe the clinical picture of orbital relapse of retinoblastoma following uncomplicated enucleation. METHODS: Case series of two patients with group E retinoblastoma with high-risk features on histopathology, namely, post-laminar optic nerve extension in one patient, and massive choroidal tumor infiltration in the other. Neither of them received adjuvant chemotherapy post enucleation. RESULTS: Both patients had orbital relapse of tumor within 4 months from enucleation, manifesting as implant migration and unstable conformer. Systemic chemotherapy and external beam radiotherapy to the orbit resulted in complete tumor regression. Both patients were tumor free at the last follow up. CONCLUSION: Implant migration post enucleation should raise the suspicion for orbital relapse of retinoblastoma. High-risk histopathology features should increase the alert in an otherwise uncomplicated enucleation for retinoblastoma.