Abstract
A 5-year-old female with bilateral familial retinoblastoma (Group A, Group C) was treated with systemic chemotherapy and three cycles of intra-arterial chemotherapy. She was being followed closely and had no evidence of intraocular recurrence for 4 years. She developed isolated femoral metastasis 5 years after initial diagnosis and was treated with high-dose chemotherapy and stem cell transplant. This case emphasizes the need for metastatic monitoring for low-grade retinoblastoma and points toward delayed tumor latency.