A 6½-year-old boy presented with a large painless mass of the left proximal humerus noted 3 weeks before admission. He was known to have had bilateral retinoblastoma 3 years earlier. On presentation, this tumor was accompanied by a large mass of the right orbit (Fig 1) without direct invasion of the leptomeninges or the bony orbit. The right eye was enucleated, and a prosthesis was placed. This was followed by chemotherapy with vincristine, doxorubicin hydrochloride, and cyclophosphamide and radiation therapy of 5500 cGy to both orbits. The patient had been considered free of tumor.
Results of the physical examination on presentation revealed a 5×5-cm immobile, hard mass in the area of the left deltoid muscle. His left eye was normal, and results of the remainder of the physical examination and routine laboratory testing were unremarkable. A chest roentgenogram and results of computed tomography of the lung were normal. Roentgenograms of