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Cotard's syndrome with glioblastoma multiforme

Published online by Cambridge University Press:  24 February 2012

Michel Reich ,
Benedicte Comet ,
Emilie Le Rhun  and
Carole Ramirez
Michel Reich*
Affiliation:
Psycho-oncology Team, Centre Oscar Lambret, Lille, France
Benedicte Comet
Affiliation:
Department of Radiotherapy, Centre Oscar Lambret, Lille, France
Emilie Le Rhun
Affiliation:
Neurology, Breast Cancer Unit, Centre Oscar Lambret, Lille, France Department of Neuro-oncology and Neurosurgery, Roger Salengro Hospital, Lille University Medical Center, Lille, France
Carole Ramirez
Affiliation:
Department of Neuro-oncology and Neurosurgery, Roger Salengro Hospital, Lille University Medical Center, Lille, France
*
Address correspondence and reprint requests to: Michel Reich, Psycho-oncology Team, Centre Oscar Lambret, 3 rue Frédéric Combemale, F-59020 Lille, France. E-mail: m-reich@o-lambret.fr
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Abstract

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.

Keywords

Glioblastoma multiformeMelancholiaPsychotic depressionCotard's syndrome
Type
Case Report
Information
Palliative & Supportive Care , Volume 10 , Issue 2 , June 2012 , pp. 135 - 139
Copyright
Copyright © Cambridge University Press 2012

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