Frontal lobe glioma and acute psychosis

A 13-year-old female patient was admitted for acute psychotic symptoms after two months of non-periodic mild fever and progressive behavioral changes. Hallucinations, delirium, disinhibition, coprolalia, and defiant behavior required admission to the Psychiatric Unit. Neurological examination and EEG werenormal. An extensive lesion involving the right frontal lobe was depicted in brain MRI. Psychiatric symptoms completely resolved after surgery. Histological diagnosis was of an Oligodendroglioma grade II, IDH mutant, and 1p/19q co-deleted. Presentation of a brain tumor with isolated psychiatric symptoms is exceptional in pediatric ages. Since acute psychotic symptoms may be misdiagnosed with a purely psychiatric disorder, the possibility of an underlying cerebral lesion must be kept in mind whatever the patient's age.