Treatment principles of ovarian teratoma with anti-N-methyl-D-aspartate receptor encephalitis.

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently discovered paraneoplastic limbic encephalitis. Ovarian teratoma is the only tumor clearly related to anti-NMDAR encephalitis occurrence. This study aimed to assess ovarian teratoma for neurological and mental symptoms highly related with anti-NMDAR encephalitis, treatment principles, and prognosis. Between June 2011 and October 2014, in Peking Union Medical College Hospital, ten patients with ovarian teratoma associated with anti-NMDAR encephalitis were enrolled. All patients underwent laparoscopic oophorocystectomy followed by immunotherapy. In nine patients, mental and neurological symptoms were significantly relieved 13.7±5.5days after surgery; however, symptoms persisted in one patient, who was still hospitalized when writing this paper. During the postoperative follow-up period, seven patients showed no mental symptoms or tumor recurrence; one subject had symptom recurrence 28days after surgery, while another patient showed suspected tumor recurrence 273days after operation. Ovarian teratoma associated with anti-NMDAR encephalitis is usually associated with neurological and mental symptoms at onset. Its manifestations are complex, and nursing care is difficult. Laparoscopic oophorocystectomy followed by immunotherapy led to symptom resolution in most patients.