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IntroductionFrontal meningiomas are benign brain tumours known for their late onset. They may be presented by only psychiatric symptoms. Thus, the diagnosis at early stages can be missed or overlooked until the tumour causes neurological deficit.Case reportWe report the case of a 61-year-old man, receiving a treatment and a follow-up for bipolar disorder for 11 years. He has history of 3 major depressive episodes, 2 suicide attempts and a manic episode. The symptoms were initially well controlled by medication. Since 6 months, the patient started to experience atypical symptoms: he had presented disinhibited and aggressive behaviour, psychomotor instability, pyromania and self-neglect. The patient did not respond to treatment despite repeated adjustments. A frontal syndrome was suspected. Cerebral CT scan revealed an unexpected mass measuring 6.8 cm × 5.6 cm at the right frontal area, suggestive of a giant meningioma (Fig 1).ConclusionsGenerally, once diagnosed, psychiatric disorders are rarely revised. Consequently, “silent” tumours such as frontal meningiomas can be overlooked. Neuroimaging should be considered in case of new-onset psychiatric symptoms, atypical or change in clinical presentation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Serial criminality, although rare, has always aroused the interest of researchers in criminology, psychiatry, psychology, and sociology. We report the case of a patient, suffering from a chronic psychotic disorder, having committed several murders over a period of 9 years, underpinned by a delirium of misidentification of Frigoli syndrome.