A common dementia in a rare disease

Area of Science:

• Neurology
• Oncology
• Psychiatry

Background:

• Depression can manifest with cognitive decline, including memory impairment.
• Rapid cognitive deterioration in elderly patients warrants thorough investigation beyond typical depression.
• Cerebral lymphomas are rare primary brain tumors that can mimic psychiatric conditions.

Purpose of the Study:

• To highlight a rare case of primary cerebral lymphoma presenting as severe depression with rapid memory decline.
• To emphasize the importance of considering organic brain pathology in patients with atypical or rapidly progressing psychiatric symptoms.
• To illustrate the diagnostic challenges in differentiating primary brain tumors from primary psychiatric disorders.

Main Methods:

• Case report of a 68-year-old male patient.
• Clinical psychiatric assessment including evaluation for electroconvulsive therapy (ECT).
• Diagnostic workup to investigate unexplained memory impairment.

Main Results:

• The patient presented with severe, subacute depressive state, psychomotor retardation, and refusal to eat.
• Memory impairment was disproportionate to the depressive state, prompting further investigation.
• Primary cerebral lymphoma of the non-Hodgkin's type was diagnosed.
• The patient died 10 weeks after initial psychiatric assessment.

Conclusions:

• Primary cerebral lymphoma can present with psychiatric symptoms mimicking severe depression and cognitive decline.
• Early and comprehensive diagnostic evaluation is crucial for identifying treatable organic causes of psychiatric symptoms.
• This case underscores the need for a multidisciplinary approach in managing complex neurological and psychiatric presentations.