Visual agnosia and prosopagnosia secondary to melanoma metástases: Case report

Agnosia visual e prosopagnosia secundárias a melanoma metastático: relato de caso

Norberto Anízio Ferreira Frota Lécio Figueira Pinto Claudia Sellitto Porto Paulo Henrique Pires de Aguia Luiz Henrique Martins Castro Paulo Caramelli About the authors

Abstract

The association of visual agnosia and prosopagnosia with cerebral metastasis is very rare. The presence of symmetric and bilateral cerebral metastases of melanoma is also uncommon. We report the case of a 34 year-old man who was admitted to hospital with seizures and a three-month history of headache, with blurred vision during the past month. A previous history of melanoma resection was obtained. CT of the skull showed bilateral heterogeneous hypodense lesions in the occipito-temporal regions, with a ring pattern of contrast enhancement. Surgical resection of both metastatic lesions was performed after which the patient developed visual agnosia and prosopagnosia. On follow-up, he showed partial recovery of visual agnosia, while prosopagnosia was still evident. The relevance of this case is the rare presentation of metastatic malignant melanoma affecting homologous occipito-temporal areas associated with prosopagnosia and associative visual agnosia.

Key words:
prosopagnosia; visual agnosia; metastasis; melanoma.

Resumo

A associação de agnosia visual e prosopagnosia com metástase cerebral são muito raras. A presença de lesões metastáticas de melanoma, simétricas e bilaterais, também é incomum. Nós descrevemos o caso de um homem de 34 anos que foi admitido no hospital com convulsões e uma história de cefaléia há três meses, com dificuldade visual no último mês. História pregressa revelava ressecção de melanoma. TC de crânio evidenciou lesões hipodensas, heterogêneas, bilaterais nas regiões occipito-temporais, com captação de contraste anelar. A ressecção cirúrgica de ambas as metástases cerebrais foi realizada e o paciente desenvolveu agnosia visual e prosopagnosia após o procedimento. Na evolução houve melhora parcial da agnosia visual enquanto a prosopagnosia ainda estava evidente. A relevância deste caso consiste na apresentação rara de melanoma maligno metastático afetando as áreas occipito-temporais homólogas associada com prosopagnosia e agnosia visual associativa.

Palavras-chave:
prosopagnosia; agnosia visual; metastase; melanoma.

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Publication Dates

  • Publication in this collection
    Jan-Mar 2007
Associação de Neurologia Cognitiva e do Comportamento Rua Itapeva, 538/ 132, 01332-000 São Paulo - SP - Brasil, Tel: (55 11)3288-8684/3288-9923 - São Paulo - SP - Brazil
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