[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-453484-105":59,"doc-detail-453484-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","behavioral-changes-and-refractory-hypertension-as-the-first-manifestations-of-anaplastic-astrocytoma-a-case-report","Behavioral Changes and Refractory Hypertension as the First Manifestations of Anaplastic Astrocytoma - A Case Report","","High-grade brain tumors are uncommon malignancies with poor survival prospects, and their early manifestations can be vague, delaying diagnosis. A case describes a 66-year-old woman whose first signs were subtle personality changes and an episode of severe, treatment-resistant hypertension. Neuroimaging identified a large right temporal lobe tumor, and biopsy confirmed anaplastic astrocytoma (WHO grade III). Because the lesion was deep, surgery was not feasible; radiotherapy started, but severe infection led to rapid deterioration and death two months after diagnosis. The report highlights vigilance in primary care when atypical behavioral changes or unexplained hypertension appear in older adults.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/behavioral-changes-and-refractory-hypertension-as-the-first-manifestations-of-anaplastic-astrocytoma-a-case-report/453484/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/behavioral-changes-and-refractory-hypertension-as-the-first-manifestations-of-anaplastic-astrocytoma-a-case-report/453484.png","ImageObject",300,407,{"name":92,"@type":93},"Theodore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What initial symptoms led to the diagnosis in this case report?","Question",{"text":112,"@type":113},"The patient first showed subtle personality/behavior changes and an episode of severe, treatment-resistant hypertension. These atypical signs prompted neuroimaging that identified a brain tumor.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did neuroimaging and biopsy confirm?",{"text":117,"@type":113},"Neuroimaging revealed a large tumor in the right temporal lobe. Biopsy confirmed anaplastic astrocytoma, WHO grade III.",{"name":119,"@type":110,"acceptedAnswer":120},"Why was surgery not performed, and what treatment was started?",{"text":121,"@type":113},"Surgical removal was not feasible because of the tumor’s deep location. Radiotherapy was initiated after diagnosis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},453484,1790894731,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},7971461740886,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Review began 11/19/2025  \nReview ended 12/03/2025  \nPublished 12/07/2025  \n© Copyright 2025  \nMarczuk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98667  \nOpen Access Case Report  \nBehavioral Changes and Refractory Hypertension as the First Manifestations of Anaplastic Astrocytoma: A Case Report  \nJulia K. Marczuk 1, Wiktoria M. Gembala 1, Adam T. Potocki 2  \n1. Department of Primary Care, Jagiellonian University Medical College, Kraków, POL 2. Family Medicine Clinic, Niepubliczny Zakład Opieki Zdrowotnej \"Eskulap-Lubno \", Kolczyglowy, POL  \nCorresponding author: Julia K. Marczuk, [juliamarczuk2001@gmail.com](juliamarczuk2001@gmail.com)  \nAbstract  \nHigh-grade brain tumors are uncommon malignancies with poor survival prospects. Their early manifestations can be vague, often resulting in diagnostic delays. Here, we report a case of a 66-year-old woman who exhibited only subtle personality changes and an episode of severe, treatment-resistant hypertension as initial signs of a malignant neoplasm in the brain. These findings prompted neuroimaging, which revealed a large tumor in the right temporal lobe. A biopsy confirmed an anaplastic astrocytoma (WHO grade III) . Because of its deep location, surgical removal was not feasible, and radiotherapy was initiated. However, the patient’s condition rapidly worsened due to severe infection, and she died two months after diagnosis. This case underscores the need for vigilance in primary care: even mild behavioral changes or atypical symptoms such as unexplained hypertension in older adults should prompt early investigation for possible brain tumors.  \nCategories: Family/General Practice, Neurology, Oncology  \nKeywords: anaplastic astrocytoma, arterial hypertension, behavioral changes, brain glioma, primary care  \nIntroduction  \nIn primary care practice, such nonspecific symptoms can easily be mistaken for internal medicine conditions or psychiatric disorders. Qualitative studies indicate that patients with brain tumors often experience a range of subtle “changes”(e.g., in speech, writing, memory, concentration), which are more often noticed by family members than by the patients themselves [1] . Moreover, such changes frequently lead to loss of interest in activities and withdrawal from daily life [1] . Classic symptoms, such as seizures, may not appear in some patients [1], which further complicates early recognition.  \nAnaplastic astrocytoma (astrocytoma anaplasticum) is a malignant brain tumor classified as a WHO grade III glioma. It accounts for approximately 1. 7% of all central nervous system neoplasms and 6-7% of gliomas in adults [2] .  \nTypically, it presents similarly to other brain tumors-with headaches, seizures, neurological deficits, or signs of increased intracranial pressure. However, the initial manifestations may sometimes be nonspecific and involve the psychological domain, such as mood changes, cognitive disturbances, or personality alterations [3] . In patients presenting with behavioral changes, the differential diagnosis must extend beyond primary psychiatric disorders. Organic causes, such as metabolic disturbances (e.g., hyponatremia, hepatic encephalopathy), endocrinopathies (e.g., Cushing’s syndrome, hyperthyroidism), intracranial neoplasms, infections (e.g., neurosyphilis, HIV), and autoimmune conditions (e.g., N-methyl-D-aspartate (NMDA) encephalitis, systemic lupus erythematosus (SLE)), should be considered early in the diagnostic process. A structured approach involving corroborative history, targeted physical examination, and basic laboratory and imaging workup is essential to avoid misattributing such symptoms to functional disorders. As emphasized by Wang et al., organic etiologies often mimic psychiatric presentations and m","cbCaijKzG2r2uzOT","https://ap.wps.com/l/cbCaijKzG2r2uzOT","pdf",2503150,"English","# Abstract\n# Introduction\n# Case Presentation","[{\"question\":\"What initial symptoms led to the diagnosis in this case report?\",\"answer\":\"The patient first showed subtle personality/behavior changes and an episode of severe, treatment-resistant hypertension. These atypical signs prompted neuroimaging that identified a brain tumor.\"},{\"question\":\"What did neuroimaging and biopsy confirm?\",\"answer\":\"Neuroimaging revealed a large tumor in the right temporal lobe. Biopsy confirmed anaplastic astrocytoma, WHO grade III.\"},{\"question\":\"Why was surgery not performed, and what treatment was started?\",\"answer\":\"Surgical removal was not feasible because of the tumor’s deep location. Radiotherapy was initiated after diagnosis.\"}]","Behavioral Changes and Refractory Hypertension as the First Manifestations of Anaplastic Astrocytoma - A Case Report | PDF",1790738950,18]