Neuropsychiatric Manifestations of a Frontal Lobe Meningioma: A Case Report

The exclusion of organic causes for psychiatric symptoms is a routine practice in mental healthcare. Brain tumors can elicit a range of mood, behavioral, or cognitive symptoms that mimic mental health disorders, significantly altering a patient's personality and behavior if left undiagnosed or untreated. This case report presents a 56-year-old Middle Eastern male with no prior history of mental illness who exhibited a three-week history of depressive symptoms, social withdrawal, and poor self-care. Despite treatment, his condition deteriorated, manifesting psychomotor retardation, urinary incontinence, paranoia, mood lability, and sexually disinhibited behavior. Neuroimaging revealed a large extra-axial mass in the anterior cranial fossa, indicative of a meningioma, necessitating referral to neurosurgery. CT and MRI scans confirmed a hyperdense mass lesion (7.1 x 7.7 x 7.5 cm), causing structural erosion and a midline shift. This case underscores the importance of considering organic causes in atypical psychiatric presentations. Meningiomas, particularly those in the frontal lobes, can present primarily with psychiatric symptoms, complicating early diagnosis. Neuroimaging is critical for accurate diagnosis and effective management in such cases. Clinicians should be vigilant for organic causes in patients with atypical psychiatric symptoms, especially in those over 50. Early neuroimaging can lead to timely diagnosis and treatment, significantly improving patient outcomes.