Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression

• Published in: BMJ case reports Vol. 13; no. 3; p. e233208
• Main Authors: Leo, Raphael Jerome, Frodey, Jill N, Ruggieri, Matthew L
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 17.03.2020; BMJ Publishing Group
• Series: Case report
• Subjects: Anxiety; Apraxia; Ataxia; Brain cancer; Brain Neoplasms - complications; Brain Neoplasms - diagnosis; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - psychology; Case reports; Delirium; Depressive Disorder - diagnosis; Diagnosis, Differential; Gait; Glioblastoma - complications; Glioblastoma - diagnosis; Glioblastoma - diagnostic imaging; Glioblastoma - psychology; Hallucinations; Headaches; Humans; Magnetic Resonance Imaging; Male; Medical prognosis; Memory; Mental depression; Mental disorders; Middle Aged; Neurocognitive Disorders - etiology; Patients; Psychosis; Reminder of Important Clinical Lesson; Tumors; Central Nervous System cancer; psychiatry
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2019-233208

Glioblastoma multiforme (GBM) is the most common of the aggressive primary brain tumours arising in adults and has a dire prognosis. Neuropsychiatric symptoms can vary significantly among afflicted persons; psychiatric disturbances may be the predominant presenting symptoms. Distinguishing between functional psychiatric disorders, particularly depression, from other subtle neuropsychiatric disturbances that may accompany GBM can be challenging. The authors present a clinical case and review of the literature in an attempt to highlight the special considerations that should be taken into account when evaluating patients who present with late-onset or atypical symptoms, refractory psychiatric symptoms, or subtle neurological disturbances signalling the need for diagnostic assessment, particularly neuroimaging, for the presence of a tumour. Early diagnosis is critical for improvement in quality of life.