Hoarding often occurs without the presence of obsessive-compulsive disorder (OCD), showing distinguishable neuropsychological and neurobiological correlates and a distinct comorbidity spectrum. Furthermore, it presents itself secondarily to other psychiatric and neurobiological disorders. Therefore hoarding disorder has been included as independent diagnosis in DSM-5.

We aim to expose the possible organic etiology of a hoarding disorder case with atypical presentation.

We present a case of a 48 years old male patient who was brought to the hospital by the police after being reported for unhealthy conditions in his home. In the home visit paid by the Social Services an excessive hoarding of objects and trash was detected. A possible hoarding disorder was diagnosed in the psychiatric assessment. Among other diagnostic test, a brain CT was conducted, in which a frontal meningioma was identified. After surgical treatment, hoarding symptoms diminished significantly.

A significant part of the hoarding disorders are attributed to primary psychiatric disorders, resulting in potentially treatable organic pathology going unnoticed.

It's important to rule out organic etiology before proceeding to make a definitive hoarding disorder diagnosis, optimizing that way the treatment options.

The authors have not supplied their declaration of competing interest.