Convexity meningioma associated with depression: a case report.

INTRODUCTION Meningiomas are slow growing, extra-axial lesions, and can be neurologically silent for a long time and present only with depression. CASE OUTLINE A 65-year-old woman developed major depression and was treated with antidepressants for two years. Depression failed to respond to drug treatment and there was no improvement. Two months before admission to hospital, due to the onset of epilepsy attack the patient underwent rein- vestigation, and a large temporal convexity meningioma, which corresponded in position to the original electroencephalography focus, was diagnosed using the computer topography of the brain. The patient underwent osteoplastic craniotomy, and a left fronto-temporal convexity meningioma of 5 cm in diameter was completely removed with its attachment to the dura. Histological examination confirmed a fibroblastic meningioma. CONCLUSION Total resection of convexity meningioma and decompression of the brain tissue in the region of limbic pathways that are involved, may contribute to a complete remission of depression symptoms. This case also illustrates the need for a prompt neuroimaging of the brain when patients present any atypical psychiatric symptoms, with late onset (> 50 years old) of the first depressive episode or fast changes of the mental state.

[1]  S. Garlow,et al.  Bifrontal meningioma presenting as postpartum depression with psychotic features. , 2013, Psychosomatics.

[2]  A. Carson,et al.  Depression in cerebral glioma patients: a systematic review of observational studies. , 2011, Journal of the National Cancer Institute.

[3]  V. Deltuva,et al.  Brain Lesions Manifesting as Psychiatric Disorders: Eight Cases , 2008, CNS Spectrums.

[4]  L. Zibners,et al.  An unusual case of a central nervous system tumor presenting as a chief complaint of depression. , 2007, Pediatric emergency care.

[5]  S. Madhusoodanan,et al.  Psychiatric manifestations of brain tumors: diagnostic implications , 2007, Expert review of neurotherapeutics.

[6]  R. Arusell,et al.  A Prospective Study of Quality of Life in Adults with Newly Diagnosed High-grade Gliomas: The Impact of the Extent of Resection on Quality of Life and Survival , 2005, Neurosurgery.

[7]  R. Kumar,et al.  Benign brain tumours and psychiatric morbidity: a 5-years retrospective data analysis. , 2004, The Australian and New Zealand journal of psychiatry.

[8]  M. Verhoef,et al.  Quality of Life in Brain Tumor Patients: The Relative Contributions of Depression, Fatigue, Emotional Distress, and Existential Issues , 2002, Journal of Neuro-Oncology.

[9]  A. Achiron,et al.  Intracranial meningiomas: correlation of peritumoral edema and psychiatric disturbances , 1995, Psychiatry Research.

[10]  G. Mihajlović,et al.  Surgical treatment of intradiploic epidermoid cyst treated as depression. , 2014, Srpski arhiv za celokupno lekarstvo.

[11]  D. Markovic,et al.  Realtionship between depression and meningiomas , 2013 .

[12]  N. Živković,et al.  Depression and brain tumors , 2012 .

[13]  M. Marković,et al.  Psychiatric manifestations of brain tumor , 2010 .

[14]  A. Ciobanu,et al.  Giant wing sphenoid meningioma with principal manifestation depression. , 2009, Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie.

[15]  I. Whittle,et al.  Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. , 1999, British journal of neurosurgery.