- 期刊
- OpenAccess
Mental Disorder Induced by Olfactory-groove Meningioma
嗅溝腦膜瘤引發精神疾病
摘要
目的：報告一名嗅溝腦膜腫瘤致精神異常並同時罹患左側腎臟癌，以頭痛、情緒障礙及精神病症狀表現的案例。病例報告：個案為四十歲女性，三年前開始漸出現憂鬱相關症狀及頭痛，二年多前開始自己察覺有嗅覺失常現象，之後精神症狀及日常生活功能逐漸惡化。之後偶發現右側腎臟癌，在遂執行手術切除後，其精神症狀仍持續惡化，檢查結果顯示一巨大嗅溝腦膜瘤，術後卻出現躁症相關症狀。在情緒穩定劑使用下，目前狀況穩定。結論：嗅溝腦膜腫瘤發病緩慢，初期常只呈現情緒症狀，本個案又同時合併左側腎臟癌，故易忽略頭痛及嗅覺失常等重大症狀。嗅溝腦膜腫瘤且同時罹患腎臟細胞瘤臨床極為罕見。
並列摘要
Object: We report on a case of olfactory-groove meningioma-induced mental dysfunction, in particular, a specific meningioma-induced mood abnormality. The relationship between the clinical presentation of the patient and the specific locale of the tumor, the resultant mental changes for the afflicted individual following tumor excision, and the patient’s prognosis are discussed herein. Case report: A forty-year-old female had experienced progressive depression-related symptoms and headache for the preceding three years, such symptoms appearing to have been precipitated by life's stresses. Her moods had appeared to have improved subsequent to medication with an antidepressant agent for the preceding two-to-three months prior to her presentation at our institution. At around the same time as commencing her antidepressant medication, this patient suffered from anosmia without recommendation. Her psychiatric symptoms progressed with apathy, indifference, avolition, fantastic hallucination, and poor self care for two years prior to her presentation at our hospital. Since she visited our medical doctor, a first-stage, right- side renal-cell carcinoma (RCC) was accidentally found and removed immediately. However, the patient's mental condition became worse. Suspecting an organic mental disorder, a brain MRI was performed, the results of which revealed a huge meningioma in the olfactory groove. Mania-related symptoms appeared post tumor excision, but her moods improved markedly after using a mood stabilizer. Conclusion: The classical onset of olfactory-groove meningioma is insidious. Symptomatic of something more serious than deemed to be the case by so-afflicted individuals, both anosmia and headache are easily neglected by a patient due to their frequent prevalence amongst individuals in a modem society. A physician might also misinterpret this tumor's early presentations as simply a matter of patient depression associated with certain somatic complaints, and as particularly associated with significant life stresses and earlier RCC. To the best of our knowledge, it is quite rare for a subject to feature, simultaneously, two different kinds of tumor which do not appear to be related to each other, this being especially the case for RCC and meningioma.