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Craniopharyngeoma presenting as psychosis, disinhibition and personality change without neurological signs

Published online by Cambridge University Press:  24 June 2014

J. Sinai  and
A. H. C. Wong
J. Sinai
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
A. H. C. Wong*
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
*
Room 711, Center for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
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Abstract

Tumors of the pituitary are associated most commonly with visual changes or endocrine abnormalities. Although a significant proportion of such tumors cause cognitive abnormalities, only a small number of cases have been reported in which the presenting symptoms are primarily ‘psychiatric’ in nature. The case described below highlights the importance of ancillary investigations in the evaluation of patients admitted to psychiatric wards. Despite the size and extension of the tumor, the patient showed no clear neurological signs, and screening serology was normal except for an elevated prolactin level. Only diagnostic imaging was able to reveal the presence of a calcified, cystic suprasellar mass that was confirmed to be a craniopharyngeoma by histopathology.

Keywords

craniopharyngeomamass lesionpsychosispituitarytumor
Type
Case Report
Information
Acta Neuropsychiatrica , Volume 15 , Issue 2 , April 2003 , pp. 94 - 96
Copyright
Copyright © 2003 Blackwell Munksgaard

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References

Heintz, P, Ehrenheim, C, Koerner, R, Kunz, U, Hundeshagen, H. MRI of intrasellar and parasellar structures with regard to psychic symptoms. Psychiatr Res 1989;29: 283–284. CrossRefGoogle ScholarPubMed
Fahlbusch, R, Honegger, J, Paulus, W, Huk, W, Buchfelder, M. Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 1999;90: 237–250.CrossRefGoogle ScholarPubMed
Crotty, TB, Scheithauer, BW, Young, WF Jret al. Papillary craniopharyngioma: a clinicopathological study of 48 cases. J Neurosurg 1995;83: 206–214.CrossRefGoogle ScholarPubMed
Shin, JL, Asa, SL, Woodhouse, LJ, Smyth, HS, Ezzat, S. Cystic lesions of the pituitary: clinicopathological features distinguishing craniopharyngioma, Rathke's cleft cyst, and arachnoid cyst. J Clin Endocrinol Metabol 1999;84: 3972–3982. Google ScholarPubMed
Adamson, TE, Wiestler, OD, Kleihues, P, Yasargil, MG. Correlation of clinical and pathological features in surgically treated craniopharyngiomas. J Neurosurg 1990;73: 12–17.CrossRefGoogle ScholarPubMed
Grattan-Smith, PJ, Morris, JG, Shores, EA, Batchelor, J, Sparks, RS. Neuropsychological abnormalities in patients with pituitary tumours. Acta Neurol Scand 1992;86: 626–631.CrossRefGoogle ScholarPubMed
Lishman, WA. Organic psychiatry, 3rd edn. Oxford: Blackwell Science, 1998. Google Scholar
Remington, FR, Rubert, SL. Why patients with brain tumors come to a psychiatric hospital: a thirty-year survey. Am J Psychiatry 1962;119: 256–257. CrossRefGoogle ScholarPubMed
Cole, G. Intracranial space-occupying masses in mental hospital patients: necropsy study. J Neurol Neurosurg Psychiatry 1978;41: 730–736.CrossRefGoogle ScholarPubMed
Holroyd, S, Cohen, MJ. Treatment of hyperprolactinemia in major depression. Am J Psychiatry 1990;147: 810.Google ScholarPubMed
Wilcox, JA.Pituitary microadenoma presenting as panic attacks. Br J Psychiatry 1991;158: 426–427.CrossRefGoogle ScholarPubMed