Serra VMA, Serra RM, Medel AMT

Language: Spanish
References: 18
Page: 1-13
PDF size: 457.58 Kb.

ABSTRACT

Introduction: Brain tumors sometimes have a complex and atypical clinical presentation at the beginning, depending on their location, which can be mistaken for psychiatric disorders.
Objective: To describe a clinical case interpreted as a psychosis for its symptoms and whose diagnosis was a highly malignant glioblastoma multiforme.
Clinical case: This is the case of a 35-year-old woman who, several months ago, started to present behavioral disorders, depressive symptoms, irritability, and conflicts at home. Clinical signs of deep depression onset, which does not improve with pharmacological treatment prescribed by the psychiatry specialist; electroconvulsive treatment is decided, after which she falls into a coma with elements of intracranial hypertension and a neurological focus. The emergency tomography shows an intracranial tumor, with necrotic areas, infiltration, and displacement of adjacent structures, as well as signs of intracranial hypertension. When microsurgical intervention is performed, she died. The necropsy revealed highly malignant glioblastoma multiforme with necrosis focuses and hemorrhage.
Conclusions: Depression and manifestations of mental disorders may have an organic cause, a fact that must be considered in the clinical setting. A well-obtained clinical history, psychopathological evaluation, and imaging techniques are currently essential tools for an accurate diagnosis.

REFERENCES

1. Keshavan MS, Kaneko Y. Secondary psychoses: an update. World Psychiatry. 2013 [acceso: 04/02/2019];12(1):4-15. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619167/

2. Graus Ribas F. Tumores intracraneales. En: Farreras-Rozman medicina interna. V-II. España: Elsevier, S.L.U; 2016. p. 1375-9.

3. Deangelis Lisa M. Tumores Intracraneales. En: Goldman-Cecil Medicine, 25th Ed. Lee G and Andrew I. España: Elsevier, S.L.U; 2017. p. 1287-95.

4. Navarro MLM, Velasco LS, Ramírez MNL, Moreno MH, Navarro, Masó MªL. "Tumores cerebrales intraaxiales en adultos." Seram 2018 [acceso: 19/04/2019]. Disponible en: https://www.piper.espacio-seram.com/index.php/seram/article/download/863/501

5. Ministerio de Salud Pública. Anuario Estadístico de Salud 2017. La Habana: Dirección Nacional de Estadísticas; 2018 [acceso: 04/04/2019]. Disponible en: Disponible en: http://www.sld.cu/sitios/dne/

6. Sierra Benítez EM, León Pérez MQ, Laud Rodríguez L, Carrillo Comas AL, Pérez Ortiz L, Rodríguez Ramos E. Wicked gliomas: molecular biology and oncogenetics detail. Rev Med Electrón. 2018 [acceso: 19/04/2019];40(4):1100-11. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1684-18242018000400016&lng=es

7. The Cancer Genome Atlas. Genomic Understanding of Glioblastoma Expanded. USA: The Cancer Genome Atlas; 2013 [acceso: 04/04/2017]. Disponible en: Disponible en: http://cancergenome.nih.gov/newsevents/newsannouncements/GBM_Expanded_news_release_2013

8. Rocha-Parra, Miguel Ángel. Glioblastoma multiforme: reporte de un caso. Lux Médica. 2018 [acceso: 19/04/2019];10(29):47-52. Disponible en: https://revistas.uaa.mx/index.php/luxmedica/article/view/768

9. Coasaca-Torres J, Alzamora-Jiménez A. Glioblastoma multiforme de larga sobrevida sin recurrencia. Reporte de caso. Revista de la Facultad de Medicina Humana. 2018 [acceso: 19/04/2019];18(2). Disponible en: https://revistas.urp.edu.pe/index.php/RFMH/article/download/1290/1181

10. Louis D, Perry A, Reifenberger G, Von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System. Acta Neuropathologica. 2016 [acceso: 19/04/2019];131(6):803-20. Disponible en: https://link.springer.com/article/10.1007/s00401-016-1545-1

11. Yan H, Parsons DW, Jin G, McLendon R, Rasheed BA, Yuan W, et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med. 2009;360(8):765-73. Disponible en: https://doi.org/10.1056/NEJMoa0808710

12. Juratli TA, Kirsch M, Robel K, Soucek S, Geiger K, von Kummer R, et al. IDH mutations as an early and consistent marker in low-grade astrocytomas WHO grade II and their consecutive secondary high-grade gliomas. J Neurooncol. 2012;108(3):403-10. Disponible en: https://doi.org/10.1007/s11060-012-0844-1

13. Aldape K, Zadeh G, Mansouri S, Reifenberger G, von Deimling A. Glioblastoma: pathology, molecular mechanisms and markers. Acta Neuropathol. 2015;129:829-48. Disponible en: https://doi.org/10.1007/s00401-015-1432-1

14. Madoz-Gúrpide A, Hillers-Rodríguez R. "Delirio de Capgras: una revisión de las teorías etiológicas." Rev Neurol. 2010 [acceso: 19/04/2019];50(7):420-30. Disponible en: https://www.academia.edu/download/38355049/delirio_de_capgras.pdf

15. Petzold J, Severus E, Meyer S, Bauer M, Daubner D, Krex D, et al. Glioblastoma multiforme presenting as postpartum depression: a case report. Journal of Medical Case Reports. 2018 [acceso: 19/04/2019];12:374. Disponible en: https://doi.org/10.1186/s13256-018-1909-3

16. Sanz-Fuentenebro, Francisco Javier. Eficacia y riesgos de la combinación de psicofármacos con el tratamiento electroconvulsivo. Revista de Psiquiatría y Salud Mental. 2011 [acceso: 19/04/2019];4(1):42-52. Disponible en: https://s3.amazonaws.com/academia.edu.documents/34582141/tec_psicofarma.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1555701730&Signature=bEh63Iw6sLvZVI3jZopNKD2nhfs%3D&response-content-disposition=inline%3B%20filename%3DEficacia_y_riesgos_de_la_combinacion_de.pdf

17. Miguel B, Urretavizcaya M. Dignificando una terapia electroconvulsiva basada en la evidencia. Rev Psiquiatr Salud Ment. 2015 [acceso: 19/04/2019];8(2):51-54. Disponible en: https://www.sciencedirect.com/science/article/pii/S1888989112001450

18. Martínez-Amorós E, Cardoner N, Gálvez V, Urretavizcaya M. Eficacia y patrón de uso de la terapia electroconvulsiva de continuación y mantenimiento en el trastorno depresivo mayor. Revista de Psiquiatría y Salud Mental. 2012 [acceso: 04/02/2019];5(4):241-53. Disponible en: https://www.sciencedirect.com/science/article/pii/S1888989112001450