EPA-1529 - Psychiatric symptoms and brain tumors: report of a case and literature review

Abstract

BackgroundBrain tumors may present with multiple psychiatric symptoms (> 50%) and in 80% of the cases tumors are located in the frontal or limbic regions. Neuropsychiatric symptoms may be the first clinical indication of a brain tumor in 18% of the patients.Brain metastatic tumors may be associated with a greater incidence of mental symptoms and are probably due to the tumors being scattered throughout the brain substance.The authors report a case of a patient where the severe psychiatric symptoms, secondary to a metastatic brain tumor, were the initial presentation of a primary lung tumor.MethodsA comprehensive review of the literature was conducted for reports of brain tumors and psychiatric symptoms, through PubMed, between Jan 1970 and Out 2010.We also reviewed the patient medical records and computed tomography (CT) scans in detail.ResultsNeither tumor location nor type is associated with specific psychiatric symptoms.Mood symptoms may be a harbinger to an evolving brain tumor.There is a statistically significant correlation of anorexia, without disturbance of body image perception, with hypothalamic tumors.ConclusionWe conclude that brain tumors can be neurologically silent and only present with psychiatric symptoms. The diagnosis and treatment in the early phase of the disease are determinant for the survival and quality of life of patients with brain tumors.Neuroimaging (CT and MRI scan) should be considered in patients with new-onset psychosis, recurrence of previously well-controlled psychiatric symptoms, occurrence of atypical symptoms and in patient's refractory to psychiatric treatment.

Chronic stress as an emerging risk factor for the development and progression of glioma

“…[ 34 , 35 ] Neuropsychiatric symptoms are the first clinical indication of a brain tumor in 18% of cases reported. [ 36 ] Although studies have speculated that mood disorders are risk factors for the development and progression of glioma, few studies have reported on the symptoms of mood disorders before diagnosis and related molecular mechanisms in glioma patients.…”