Dear Mrs and Mr Gharavi,

I have reviewed the CT an MRI images of your son Parham.

The left temporo-occipital deep space occupying lesion is

compatible with a glioma or a primitive neuro-ectodermal

tumor (PNET) or with a teratoma, although this last type

of tumor is usually symptomatic at an ealier age.

Personnaly I would operate this child , trying to remove

as much as possible and then discuss with our colleague of

pediatric oncology according to the result of microscopic

examination of the pathologic tissue.

I would not favor a biopsy as a first approach.

This growth can be removed by a left temporo-occipital

transcortical approach (between T1 an T2), the risk of

speech impairement and visual field deficit are minimal

but still exist.

I remain at your disposal if you have any other questions

Sincereley yours,

B. Rilliet,

Neurosurgeon

Hopital Cantonal Universitaire

Geneva

Switzerland

Parham Memorial

The Children's Hospital Medical Center

Mofid Kids Hospital

Behgar Tavan

Surgery Centre

Tel/Fax: +98 21 2900679    +98 21 2227207

E-Mail: Info@ParhamMedical.org