A Case Report on a Common Tumour With an Uncommon Presentation: Glioblastoma

The most common type of primary brain tumour in adults is gliomas although rare. Glioblastomas are a subtype of gliomas with the worst prognosis having the ability to rapidly increase in size, even doubling within days to weeks. Patients can present with varied presentations depending on the site of the involvement, thus misleading in diagnosis due to vagueness. The most common clinical presentations include headaches, seizures, and focal neurological signs. However, there can be atypical presentations like personality changes and back pain due to meningeal irritation which may be the only presenting complaint in the early stages. Magnetic resonance imaging (MRI) is usually considered the only investigation required for the diagnosis of the illness. However, it can mislead in the early stages. Therefore, brain biopsy remains the gold standard in the diagnosis of glioblastoma multiforme. It is important to identify the subtype to decide on the prognosis and plan the management thereafter. Here, we present a 49-year-old woman with prominent personality changes, depressive symptoms, and atypical brain imaging findings. The definitive diagnosis was made with the brain biopsy as two MRI findings were contradictory. This article highlights the importance of suspicion of primary brain tumours in adults presenting with atypical neuropsychiatric manifestations.