Objectives:
Report a case of a patient with marked depressive symptoms diagnosed with a 6X6x6 cm meningioma

Background:
Numerous organic pathologies, among which CNS disorders, present psychiatric symptoms. In some cases, patients may present with mood changes, such as depression or mania, psychotic symptoms, panic attacks, changes in personality, or memory difficulties. These can arise either as an initial presentation or with the evolution of the disorder itself. It is therefore particularly important to recognize differential diagnosis of symptoms presented by the patients. 

Materials and Methods:
Clinical case presentation through retrospective review of clinical notes and nonsystematic literature review on this topic.

Results and Conclusions:
We present a case of a 70-year-old woman, with history of Recurrent Major Depressive Disorder, admitted to inpatient psychiatric ward. She had previously responded well to antidepressive treatment, but her symptoms have been progressively worsening for the last 3 years, presenting marked adynamia and functional impairment. Head MRI head revealed a 6x6x6cm meningioma, conditioning frontal lobes and supratentorial ventricular system deformation, depression of the hypothalamus and the left ventricle, as well as a left deviation of the median structures which require surgery. However, surgery was refused by the patient and there was only slight improvement of the patient’s condition. 

Our case intends to emphasize the importance of the diagnostic evaluation in the case of resistant conditions, in the sense of improving the treatment and reducing the suffering.

666: THE NUMBER OF (THE BEAST) ADYNAMIA