« L'extraction de la pierre de folie » : impact de la découverte d'une tumeur frontale calcifiée chez un patient mélancolique

Mood disorders can take some atypical, hermetic, inaccessible aspects. The case of a young officer submerged by death impulses questions us about the origin of a melancholic depressive recurrent disorder since two years. The brutal rupture with his previous state, the resistance to antidepressants, the obstinate negative symptoms and an unexplained escape incite us to ask for a cerebral imagery: “the left frontal lobe is invaded by a 6 cm diameter calcified mass”. The comorbidity between cerebral tumor and mood disorders isn't frequent. Yet, their intricacy is revealed here in the order of the real, the imaginary and the symbolic. This “pierre de folie” hides a previous structural failure. Far to heal it, the extraction of the tumor confronts our patient to a psychic emptiness. The therapeutic strategies should respect this narcissistic fragility ready to blow out.