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Mental Disorder Induced by Olfactory-groove Meningioma

Carol Sheei-Meei Wang, M.D.1,2, Yen Kuang Yang, M.D.2, Hsin-Yi Lo,M.D.2, Yu Chang Hung, M.D.3, Tzung Lieh Yeh, M.D.2, Ming-JenYang, M.D., Sc.D.2

Object: We report on a case of olfactory-groove meningioma-induced mental dysfunction, in particular, a specific meningioma-induced mood abnormality. The relationship between the clinical presentation of the patient and the specific locale of the tumor, the resultant mental changes for the afflicted individual following tumor excision, and the patient's prognosis are discussed herein. Case report: A forty-year-old female had experienced progressive depression-related symptoms and headache for the preceding three years, such symptoms appearing to have been precipitated by life's stresses. Her moods had appeared to have improved subsequent to medication with an antidepressant agent for the preceding two-to-three months prior to her presentation at our institution. At around the same time as commencing her antidepressant medication, this patient suffered fromanosmia without recommendation. Her psychiatric symptoms progressed with apathy, indifference, avolition, fantastic hallucination, and poor self care for two years prior to her presentation at our hospital. Since she visited our medical doctor, a first-stage, rightside renal-cell carcinoma (RCC) was accidentally found and removed immediately. However, the patient's mental condition became worse. Suspecting an organic mental disorder, a brain MRI was performed, the results of which revealed a huge meningioma in the olfactory groove. Mania-related symptoms appeared post tumor excision, but her moods improved markedly after using a mood stabilizer. Conclusion: The classical onset of olfactory-groove meningioma is insidious. Symptomatic of something more serious than deemed to be the case by so-afflicted individuals, both anosmia and headache are easily neglected by a patient due to their frequent prevalence amongst individuals in a modern society. A physician might also misinterpret this tumor's early presentations as simply a matter of patient depression associated with certain somatic complaints, and as particularly associated with significant life stresses and earlier RCC. To the best of our knowledge, it is quite rare for a subject to feature, simultaneously, two different kinds of tumor which do not appear to be related to each other, this being especially the case for RCC and meningioma.
Key Word olfactory-groove meningioma, depression, mania, anosmia
Editorial Committe, Taiwanese Journal of Psychiatry
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