The Smiths are concerned about their 9-month-old daughter Jane. They have noticed that her eyes are not aligned sometimes (strabismus). The family physician plots her weight, height and head circumference; performs a general well-baby exam along with an eye examination. They are unable to see a “red reflex” in either eye; the retina appears white (leukokoria). Jane is otherwise well and demonstrates normal 9-month-old development. The family physician inquires about the family history and they report that Mr. Smith had a younger brother who died as a child of ‘eye cancer’. His father, who was blind in one eye, died of bone cancer. Mrs. Smith reports that her mother died of breast cancer. The patient is referred urgently to a pediatric ophthalmologist who evaluates Jane and performs ophthalmoscopy under anesthesia. The parents are informed that Jane has tumours in both eyes; one is larger than the other.