The role of the insula: Diagnosis of a brain tumor in a patient with schizophrenia

Introduction

Gliomas are rare, slow-growing brain tumors. The insula is related to self-knowledge, theory of the mind, interpersonal relationships, distortion of reality and the appearance of positive symptoms. There is little current literature on these type of tumors in the insula and psychosis.

Clinical case

A 32-year-old male patient, diagnosed with Paranoid Schizophrenia with significant auditory hallucinations, and a low-grade glioma in the left insular region on routine brain MRI examination. We discuss the possible relationship between the persistence and refractoriness of psychotic symptoms with this finding.

Discussion

The insula may be the main affected brain region in schizophrenia. In psychotic patients, deficits in the insular structure are associated with the presence and severity of positive and negative symptoms. They had reduced volumes of bilateral gray matter from the insula, especially on the right side.