a1 Psycho-oncology Team, Centre Oscar Lambret, Lille, France
a2 Department of Radiotherapy, Centre Oscar Lambret, Lille, France
a3 Neurology, Breast Cancer Unit, Centre Oscar Lambret, Lille, France
a4 Department of Neuro-oncology and Neurosurgery, Roger Salengro Hospital, Lille University Medical Center, Lille, France
Objective: Brain tumors are classically associated with neurological and/or psychiatric symptomatology. Behavioral or cognitive disorders can underlie delirium, personality changes, psychotic reactions, and mood disorders.
Method: To illustrate this, we report the case of a 60-year-old male patient confronted with an inoperable glioblastoma multiforme on the splenium of the corpus callosum, of poor prognosis, treated by concomitant radiochemotherapy with temozolomide, who developed psychotic depression with Cotard's syndrome. Clinical manifestations of this syndrome with untoward consequences in terms of prognosis are classically characterized by intense moral suffering, indignity and pessimistic fixations, suicidal ideations, and a nihilistic delusion relating to one's own body.
Results: Nevertheless, this association between Cotard's syndrome and glioblastoma has been seldom described. To our knowledge, this is the first time that this has been described as a complication of this particular tumor location. Some neuropsychopathological hypotheses are proposed, which involve medical, iatrogenic, and psychogenesis issues.
Significance of results: This case report points to the necessary collaboration between psychiatrists, neuro-oncologists and radiation oncologists in improving the patient's management and quality of life.
(Received March 06 2011)
(Accepted April 09 2011)
This work was presented as a poster at the 9th Congress of Encéphale, Paris, January 2011.