Frontal Lobe Syndrome: Given the history of brain stem stroke and oligodendroglioma, along with symptoms of anger outbursts, rage, destruction of property, personality changes, feeling of being worthless, and lack of ambition, frontal lobe syndrome is a strong consideration. The brain stem stroke could have affected areas of the brain responsible for emotional regulation and behavior, leading to these symptoms.

Depression: The symptoms of feeling worthless, lack of ambition, and personality changes could be indicative of a depressive disorder, which is common in patients with chronic illnesses and history of stroke.
Anxiety Disorder: The presence of anger outbursts and rage could also suggest an underlying anxiety disorder, which may be exacerbated by the patient's physical condition and dissatisfaction with his care.
Steroid-Induced Psychosis: Given the patient's history of chronic steroid use, steroid-induced psychosis is a possible diagnosis, as long-term steroid use can lead to mood changes, irritability, and even psychotic episodes.
Post-Stroke Depression and Anxiety: These are common complications following a stroke and could explain the patient's mood changes, lack of ambition, and emotional outbursts.

Antiphospholipid Syndrome: Although the patient is being referred to hematology for evaluation of his positive antiphospholipid antibodies, it's crucial not to miss the potential for this syndrome to cause or contribute to his neurological and psychiatric symptoms.
Tumor Recurrence: Given the patient's history of oligodendroglioma, it's essential to consider the possibility of tumor recurrence, which could be causing or contributing to his current symptoms.
Adrenal Insufficiency Crisis: The patient's history of adrenal insufficiency necessitates consideration of an adrenal crisis, especially if he is experiencing significant stress or if his steroid replacement regimen is not adequately managed.

Cushing's Syndrome: Although less likely, given the patient's chronic steroid use, Cushing's syndrome could be a consideration, especially if there are concerns about the adequacy of his steroid replacement regimen or potential overuse of steroids.
Paraneoplastic Syndrome: This is a rare condition where the body's immune response to a tumor causes neurological symptoms. Given the patient's history of oligodendroglioma, this is a rare but possible diagnosis to consider.