A boy with bilateral retinoblastoma underwent metastatic surveillance for increased risk of systemic and central nervous system metastasis because of the extensive choroid and optic nerve invasion in his enucleated eye. Two years after finishing chemotherapy, surveillance MRI showed multiple new liver, lung and spinal cord lesions. High Toxocara antibody titers, eosinophilia, and elevated IgE levels supported a diagnosis of toxocariasis, rather than retinoblastoma metastasis. This is the first report of early, asymptomatic spinal cord toxocariasis diagnosed incidentally through metastatic surveillance.
From the *Division of Infectious Diseases, †Department of Pediatric Laboratory Medicine, ‡Division of Hematology/Oncology, and Departments of §Pediatrics, ¶Ophthalmology/Visual Science, and ∥Diagnostic Imaging, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.
Accepted for publication August 14, 2008.
Supported in part by grants from the National Cancer Institute of Canada and the Ontario Institute for Cancer Research (to H.S.L.C. and B.L.G.), and from the Canadian Retinoblastoma Society and the Royal Arch Masons of Canada (to B.L.G.).
Address for correspondence: Helen Chan, MBBS, The Hospital for Sick Children, Division of Hematology/Oncology, 555 University Ave, Toronto, Ontario, Canada M5G 1X8. E-mail: email@example.com.