Avoidant/restrictive food intake disorder-like syndrome and cerebellar tumor in an adolescent: a case report.

Abstract

Background: Avoidant/Restrictive Food Intake Disorder (ARFID) is a recently recognized eating disorder category in the DSM-5 and ICD-11classifications. Recent functional neuroimaging studies have suggested alterations in the cerebellar intrinsic connectivity networks in patients suffering from eating disorders. Associations between eating disorders and central nervous system tumors have been documented, but to date no studies have linked eating disorders to cerebellar lesions. This case report presents a 13-year-old boy with ARFID symptoms and a cerebellar tumor, exploring the potential connection between the two.

Case presentation: A 13-year-old adolescent with a history of dental agenesis, escalating food restriction, severe abdominal pain, impaired weight gain and statural growth was initially diagnosed with ARFID. A brain magnetic resonance imaging revealed a large and threatening cerebellar tumor, leading to urgent neurosurgery. After tumor removal, the patient's eating behaviors, weight, and growth but also puberty improved dramatically. One year later, a tumor remnant was found, necessitating targeted therapy.

Conclusions: This case underscores the possibility that cerebellar tumors can mimic ARFID-like syndrome, suggesting a neurological origin for the observed disordered eating behaviors. The marked improvement in eating patterns and growth after tumor removal strongly suggests a direct link between the cerebellar tumor and the patient's symptoms. Given the rarity and complexity of such cases, neurological evaluations, including brain magnetic resonance imaging, should be considered in any children and adolescents with eating disorder or severe disordered eating especially when growth is affected, or unusual symptoms are present.

Level of evidence: level V, case report.