Objective: To outline the clinical manifestations, imaging, management and prognosis of patients with liver metastases of retinoblastoma (RB).

Methodology: Retrospective analysis of two cases diagnosed with liver metastasis of RB between 2018 and 2023 at the National Institute of Neoplastic Diseases in Lima, Peru.

Results: A total of 2 (0.71%) out of 283 patients had liver metastases from RB, as confirmed by pathology. A 12-month-old female patient with unilateral RB pT1 without risk factors remains under observation after enucleation. After 5 months, she presented with multiple heterogeneous hepatic lesions up to 10 cm in size, with a hypodense center and slightly contrast-enhancing surface. She received chemotherapy and died 7 months later. The second case was a 2-year-old female with unilateral RB, pT3b and G3 with retrolaminar involvement of the optic nerve and choroidal invasion. She received adjuvant chemotherapy. After 21 months, she presented with multiple hypodense lesions with diffuse distribution in hepatic parenchyma, with distinct peripheral enhancement, some of which were confluent. She died without treatment 1 month later.

Conclusion: Hepatic metastasis of RB is rare. In these two cases, they were presented as heterogeneous, predominantly hypodense lesions with mild contrast enhancement on the CT scan. These events were simultaneously associated with recurrence in the central nervous system, even in the absence of risk factors for metastasis and dissemination.