Diagnostic Challenges in an Elderly Patient With Cognitive Decline and an Incidental Brain Mass
Year: 2025
Type: article
Study design: Case Report
Abstract: Cognitive impairment in the elderly is often attributed to neurodegenerative processes such as dementia or delirium. However, in some cases, structural brain lesions, including malignancies like glioblastoma and lymphomas, can present similarly. This case report is of a 79-year-old male with progressive cognitive decline who was initially suspected to have dementia but was later found to have a brain mass. The absence of focal neurological deficits and a normal initial CT scan delayed the recognition of an underlying malignancy. An MRI ultimately revealed a lesion concerning glioblastoma or primary central nervous system lymphoma (PCNSL). Given the patient's frailty, the neuro-oncology multidisciplinary team (MDT) recommended best supportive care rather than an invasive biopsy. This case underscores the importance of thorough assessment and neuroimaging in cases of unexplained cognitive decline and highlights the diagnostic pitfalls that can lead to misdiagnosis.
Source: Cureus
DOI: 10.7759/cureus.82987
Authors: Adi Ahmed, George Okwuasaba
Institutions: Scarborough Health Network, Scarborough General Hospital
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409798185