GLIOBLASTOMA PRESENTED WITH DEPRESSION AND PERSONALITY CHANGES: A CASE REPORT

Yıl 2021, Cilt: 84 Sayı: 2, 281 - 284, 25.04.2021

Yaşar Kapıcı Olga Bayar Kapıcı Aslı Egeli Atilla Tekin

https://doi.org/10.26650/IUITFD.2020.0082

Öz

Glioblastoma is the most common poor prognosis brain tumor in adults. Although neurological signs are often seen as first symptoms at clinical course of GBM, pychiatric symptoms also accompany the presentation. Mood and personality changes, anxiety and psychosis are the most common psychiatric symptoms in presentation of GBM. In this article, a 57-year-old man admitted to emergency unit with social isolation, anhedonia, loss of appetite, sleep disturbances and personality changes is reported. In this case, a 7x4 cm-sized lesion with a mass effect from the left frontoparietal region and extending to the temporal lobe was found.

Anahtar Kelimeler

Glioblastoma, anhedonia, depression, personality changes

DEPRESYON VE KİŞİLİK DEĞİŞİKLİLERİ İLE ORTAYA ÇIKAN GLİOBLASTOMA: BİR OLGU SUNUMU

Öz

Glioblastoma, erişkinlerde en sık görülen kötü prognozlu bir beyin tümörüdür. Her ne kadar GBM’nin klinik seyrinde ilk semptomlar nörolojik belirtiler şeklinde olsa da, psikiyatrik belirtiler de eşlik edebilir. Duygudurum ve kişilik değişiklikleri, anksiyete ve psikoz GBM’de en sık görülen psikiyatrik belirtilerdir. Bu yazıda, acil servise sosyal içe çekilme, anhedoni, iştahsızlık, uyku düzensizliği ve kişilik değişiklileri ile başvuran 57 yaşında bir erkek hasta bildirilmiştir. Bu olguda, beyin görüntüleme incelemelerinde 7x4 cm büyüklüğünde sol frontoparietal bölgeden başlayıp temporal loba uzanan ve kitle etkisi gösteren bir lezyon saptandı.

Anahtar Kelimeler

Glioblastoma, anhedoni, depresyon, kişilik değişiklikleri

Kaynakça

• 1. Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008-2012. Neuro Oncol 2015;17(Suppl 4):iv1-62. [CrossRef]
• 2. Wen PY, Kesari S. Malignant gliomas in adults. N Engl J Med 2008;359:492-507. [CrossRef]
• 3. Keschner M, Bender MB, Strauss I. Mental symptoms associated with brain tumor: a study of 530 verified cases. JAMA 1938;110:714-8. [CrossRef]
• 4. Madhusoodanan S, Danan D, Moise D. Psychiatric manifestations of brain tumors: diagnostic implications. Expert Rev Neurother 2007;7(4):343-9. [CrossRef]
• 5. Mugge L, Mansour TR, Crippen M, Alam Y, Schroeder J. Depression and glioblastoma, complicated concomitant diseases: A systemic review of published literature. Neurosurg Rev 2020;43(2):497-511. [CrossRef]
• 6. Leo RJ, Frodey JN, Ruggieri ML. Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression. BMJ Case Reports CP 2020;13(3):e233208 [CrossRef]
• 7. Cheema FA, Badr A, Iqbal J. Glioblastoma multiforme presenting as treatmentresistant depression. J Neuropsychiatry Clin Neurosci 2010;22(1):123-e126. [CrossRef]
• 8. Madhusoodanan S, Danan D, Moise D. Psychiatric manifestations of brain tumors: diagnostic implications. Expert Rev Neurother 2007;7(4):343-9. [CrossRef]
• 9. Moise D, Madhusoodanan S. Psychiatric symptoms associated with brain tumors: a clinical enigma. CNS Spectr 2006;11(1):28-31. [CrossRef]
• 10. Yapıcı-Eser H, Onay A, Öztop-Çakmak Ö, Egemen E, Vanlı-Yavuz EN, Solaroğlu İ. Rare case of glioblastoma multiforme located in posterior corpus callosum presenting with depressive symptoms and visual memory deficits. BMJ Case Rep 2016;2016:pii:bcr2016216505. [CrossRef]
• 11. Zhang YY, Ruan LX, Zhang S. Rapid progression of glioblastoma multiforme: a case report. Oncol Lett 2016;12(6):4803-6. [CrossRef]
• 12. Szczepanski SM, Knight RT. Insights into human behavior from lesions to the prefrontal cortex. Neuron 2014;83(5):1002-18. [CrossRef]
• 13. Dixon ML, Thiruchselvam R, Todd R, Christoff K. Emotion and the prefrontal cortex: an integrative review. Psychol Bull 2017;143(10):1033. [CrossRef]
• 14. Franssen A, Sienaert P. Temporal glioblastoma presenting as catatonia. BMJ Case Rep 2019;12(3):e224017. [CrossRef]
• 15. Petzold J, Severus E, Meyer S, Bauer M, Daubner D, Krex D, Juratli TA. Glioblastoma multiforme presenting as postpartum depression: a case report. J Med Case Rep 2018;12(1):1-4. [CrossRef]
• 16. Zivković N, Marković M, Mihajlović G, Jovanović M. Surgical treatment of intradiploic epidermoid cyst treated as depression. Srp Arh Celok Lek 2014;142(1):67-71. [CrossRef]
• 17. Collins A, Sundararajan V, Brand CA, et al. Clinical presentation and patterns of care for short-term survivors of malignant glioma. J Neurooncol 2014;119(2):333-41. [CrossRef]
• 18. Sundararajan V, Bohensky MA, Moore G, et al. Mapping the patterns of care, the receipt of palliative care and the site of death for patients with malignant glioma. J Neurooncol 2014;116(1):119-26. [CrossRef]
• 19. Arber A, Hutson N, de Vries K, Guerrero D. Finding the right kind of support: a study of carers of those with a primary malignant brain tumour. Eur J Oncol Nurs 2013;17(1):52-8. [CrossRef]
• 20. Assefa D, Haque FN, Wong AH. Case report: anxiety and fear in a patient with meningioma compressing the left amygdala. Neurocase 2012;18(2):91-4. [CrossRef]
• 21. Cheema FA, Badr A, Iqbal J. Glioblastoma multiforme presenting as treatment-resistant depression. J Neuropsychiatry Clin Neurosci 2010;22(1):123.E26 [CrossRef]
• 22. Bunevicius A, Deltuva VP, Deltuviene D, Tamasauskas A, Bunevicius R. Brain lesions manifesting as psychiatric disorders: eight cases. CNS Spectr 2008;13(11):950-8. [CrossRef]
• 23. Paul RH, Piatt AL, Whelihan WM, Malloy PF. Neuropsychological and magnetic resonance imaging abnormalities associated with a plasmacytoma of the frontal dura: a case report. Neuropsychiatry Neuropsychol Behav Neurol 2000;13(2):143-7.