title: Visual agnosia after treatment of a posterior fossa ependymoma in a 16-month-old girl.
abstract: We present the clinical observation of a 16-month-old girl treated for a posterior fossa ependymoma who experienced severe and delayed visual dysfunction. She was initially treated by surgery and conventional chemotherapy. When she relapsed at age 3 years, the salvage treatment combined high-dose chemotherapy, second surgery, and local irradiation. At age 4 years, disturbed gait and dysarthric speech appeared rapidly, and she became unable to recognize objects and people. Computed tomography revealed bilateral calcifications in the cerebellum and temporal and occipital lobes but no relapse. The neuropsychologic evaluations revealed signs of visual agnosia and marked intellectual impairment. The role of the different treatment modalities in the pathogenesis of this unusual syndrome is discussed.
authors.affiliation: Department of Pediatrics, Gustave Roussy Institute, Villejuif, France. ONCOPED@igr.fr
authors.forename: V
authors.initials: V
authors.lastname: Kieffer-Renaux
authors.forename: C
authors.initials: C
authors.lastname: Bulteau
authors.forename: J
authors.initials: J
authors.lastname: Grill
authors.forename: C
authors.initials: C
authors.lastname: Levy-Piebois
authors.forename: D
authors.initials: D
authors.lastname: Couanet
authors.forename: A
authors.initials: A
authors.lastname: Pierre-Kahn
authors.forename: O
authors.initials: O
authors.lastname: Hartmann
authors.forename: C
authors.initials: C
authors.lastname: Kalifa
mesh_terms: D000377:Agnosia / Q000175:diagnosis / Q000209:etiology*; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003388:Cranial Fossa, Posterior / Q000601:surgery; D004806:Ependymoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D018714:Radiotherapy, Adjuvant; D012086:Reoperation