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Revista Cubana de Medicina General Integral

On-line version ISSN 1561-3038

Abstract

SERRA VALDES, Miguel A.; SERRA RUIZ, Melissa  and  MEDEL AGUERO, María Teresa. Depressive Psychosis as an Onset Symptom of a Brain Tumor. Rev Cubana Med Gen Integr [online]. 2020, vol.36, n.2  Epub July 01, 2020. ISSN 1561-3038.

Introduction:

Brain tumors sometimes have a complex and atypical clinical presentation at the beginning, depending on their location, which can be mistaken for psychiatric disorders.

Objective:

To describe a clinical case interpreted as a psychosis for its symptoms and whose diagnosis was a highly malignant glioblastoma multiforme.

Clinical case:

This is the case of a 35-year-old woman who, several months ago, started to present behavioral disorders, depressive symptoms, irritability, and conflicts at home. Clinical signs of deep depression onset, which does not improve with pharmacological treatment prescribed by the psychiatry specialist; electroconvulsive treatment is decided, after which she falls into a coma with elements of intracranial hypertension and a neurological focus. The emergency tomography shows an intracranial tumor, with necrotic areas, infiltration, and displacement of adjacent structures, as well as signs of intracranial hypertension. When microsurgical intervention is performed, she died. The necropsy revealed highly malignant glioblastoma multiforme with necrosis focuses and hemorrhage.

Conclusions:

Depression and manifestations of mental disorders may have an organic cause, a fact that must be considered in the clinical setting. A well-obtained clinical history, psychopathological evaluation, and imaging techniques are currently essential tools for an accurate diagnosis.

Keywords : glioblastoma; intracranial tumor; intracranial hypertension; secondary psychosis; CAT.

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