Ovarian teratoma associated with anti-N-methyl-D-aspartate receptor encephalitis：a report of 5 cases and review of the literature

Abstract

Objective To report the clinical features of ovarian teratoma in patients with anti-N-methyl-D-aspartate receptor ( NMDAR ) encephalitis .Methods The clinical information of five female patientswith ovarian teratoma and anti-NMDAR encephalitis in Peking Union Medical College Hospital and Beijing Tiantan Hospital affiliated to Capital Medical University from June 2011 to May 2013 were obtained . Relevant literatures were reviewed .Results The initial symptoms varied from respiratory prodromes or emotional incentives before the onset of psychiatric symptoms .Patients always presented with psychosis , bizarre dyskinesia and seizures . Antibodies to NMDAR in serum and cerebrospinal fluid ( CSF ) were positive;The psychiatric symptoms were dramatically relieved by tumor reception and immunotherapy which occured in inverse order of symptom development .No evidence of tumor recurrence was observed during a short-time follow-up after the surgery .Conclusions Ovarian teratoma with anti-NMDAR encephalitis always presents with psychiatric symptoms which could be misdiagnosed as psychiatric diseases .Patients respond to tumor resection and immunotherapy . Key words: Ovarian teratoma ; Anti-N-methyl-D-aspartate receptor encephalitis ;