Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 4 2025 11 17 264 266 Seyeh Hamzeh Hosseini Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Hamed Ghazvini Department of Neuroscience, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Seyedeh Masoumeh Seyedhosseini Tamijani Department of Neuroscience, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Raheleh Rafaiee Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran . 2024 08 12 2025 07 26 Brain tumors manifest with neurological symptoms as a result of mass effects. Occasionally, brain tumors may manifest with an initial psychiatric presentation in the absence of neurological deficits or symptoms. We present a case of a 54-year-old woman who showed increased energy, elevated mood, delusions, and headache. Symptoms of psychosis and mania began about two months ago and have worsened over the past month. Neurological examinations are normal. MRI of the brain confirmed the tumor on the left frontal lobe. A craniotomy and tumor resection were performed and the final diagnosis was meningioma (meningotheliomatous, WHO grade I). However, manic symptoms have been documented to occur more frequently in right frontal tumors. Early neuroimaging and a high index of suspicion are crucial to avoid misdiagnosis and ensure timely treatment of brain tumors with psychiatric symptoms. https://acta.tums.ac.ir/index.php/acta/article/view/11199 https://acta.tums.ac.ir/index.php/acta/article/download/11199/5979