A case illustrated the challenge in distinguishing between symptoms attributable to a psychiatric condition in individuals with a history of mental illness and those stemming from a central nervous system tumor involved a 61-year-old woman with a history of bipolar 1 disorder, generalized anxiety, and prior psychiatric hospitalizations. She presented to the emergency department with worsening depressive symptoms but without any focal neurological deficits. Initially presumed to be experiencing a psychiatric episode, she was planned for transfer to an inpatient psychiatric facility; however, an MRI revealed a frontal brain lesion suggestive of a meningioma, leading to her transfer to a tertiary center for neurosurgical intervention. After undergoing a successful bifrontal craniotomy to excise the neoplasm, the patient showed improvement in her symptoms at subsequent postoperative visits. This case underscores the need for neuroimaging in patients presenting with atypical cognitive symptoms and highlights the complex interplay between psychiatric disorders and brain tumors, stressing the importance of considering neuroimaging in differential diagnoses to avoid delayed treatment.
Reference: Lally J, Galarneau D. Psychiatric Manifestations as the Primary Presentation of Frontal Meningioma. Ochsner J. 2023 Summer;23(2):167-171. doi: 10.31486/toj.22.0112. PMID: 37323514; PMCID: PMC10262947.
