The patient was a 22 year old man who was admitted for resection of Ewing's sarcoma (peripheral/primitive neuroepithelial tumor- PNET). Vaguely described visual difficulty was noted retrospectively to have begun approximately one month prior to admission. He underwent thoracotomy for pulmonary metastasis, and was noted after recovery to have trouble with concentration and increasing visual difficulty. On exam, he was inattentive, confused and had a right homonomous hemianopia, a left inferior quadrantanopia, right lower extremity hyperreflexia, and right extensor plantar response.