Olfactory Fossa Meningioma Presenting as Depressive Disorder: A Case Report

Area of Science:

• Neurology
• Neuro-oncology
• Psychiatry

Background:

• Meningiomas are common intracranial tumors, often benign and slow-growing.
• They can present atypically with psychiatric symptoms rather than neurological deficits.
• Olfactory fossa meningiomas are a subtype that can manifest with mental health issues.

Observation:

• A case report details a middle-aged man with a two-year history of depressive disorder.
• The patient developed mental status changes and urinary incontinence, leading to the diagnosis of a large olfactory fossa meningioma.
• This presentation highlights the potential for meningiomas to be misdiagnosed as primary psychiatric conditions.

Findings:

• Surgical removal of the olfactory fossa meningioma led to the resolution of the patient's depressive symptoms.
• Neurocognitive functions significantly improved following the tumor resection.
• The case underscores the importance of considering organic brain lesions in psychiatric presentations.

Implications:

• Recommends brain imaging for middle-aged and older adults with new-onset psychiatric symptoms to rule out meningiomas.
• Suggests evaluating neuropsychological and psychiatric profiles for clues to expedite meningioma identification.
• Highlights that while surgical intervention can improve cognitive function, complete recovery is not always guaranteed.