Complete recovery from paraneoplastic anti-NMDAR encephalitis associated with a small ovarian teratoma following a laparoscopic salpingo-oophorectomy: A case report

Imai,Kenji; Fukuda,Takeshi; Wada,Takuma; Kawanishi,Masaru; Yamauchi,Makoto; Hashiguchi,Yasunori; Ichimura,Tomoyuki; Yasui,Tomoyo; Sumi,Toshiyuki

doi:10.3892/etm.2015.2344

May-2015 Volume 9 Issue 5

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May-2015 Volume 9 Issue 5

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Case Report

Complete recovery from paraneoplastic anti-NMDAR encephalitis associated with a small ovarian teratoma following a laparoscopic salpingo-oophorectomy: A case report

Authors:
- Kenji Imai
- Takeshi Fukuda
- Takuma Wada
- Masaru Kawanishi
- Makoto Yamauchi
- Yasunori Hashiguchi
- Tomoyuki Ichimura
- Tomoyo Yasui
- Toshiyuki Sumi
View Affiliations / Copyright

Affiliations: Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka City University, Osaka 545‑8585, Japan
Pages: 1723-1726
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Published online on: March 11, 2015

https://doi.org/10.3892/etm.2015.2344
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Abstract

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a severe but treatment‑responsive disorder, initially identified in young women with an ovarian teratoma. Symptoms include mood, behavior and personality irregularities that resemble acute psychosis. The present study reports the rare case of a patient with anti‑NMDAR encephalitis and severe neurological symptoms, that exhibited a rapid recovery following a laparoscopic salpingo‑oophorectomy. The 39‑year‑old woman was admitted to the Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine (Osaka, Japan) with a 5‑day history of fever and stomach ache. One week later, the patient developed hallucinations and emotional lability. Initially, a diagnosis of limbic or herpes encephalitis was considered; thus, the patient was administered acyclovir and received steroid pulse therapy. However, the patient subsequently developed apnea, and in response, a tracheal intubation, mechanical ventilation and plasmapheresis were performed. Anti‑NMDAR encephalitis was subsequently considered as a diagnosis and mediastinal and pelvic computed tomography (CT) examinations were conducted to detect for the presence of a teratoma. A 24x24‑mm cystic lesion was identified in the pelvis from an abdominal CT scan and the lesion appeared to be an ovarian teratoma. In addition, serum and cerebrospinal fluid samples were collected, and were found to test positive for anti‑NMDAR antibodies. A laparoscopic salpingo‑oophorectomy was performed, which resulted in rapid improvement of the patient's mental symptoms, followed by a complete recovery.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Complete recovery from paraneoplastic anti-NMDAR encephalitis associated with a small ovarian teratoma following a laparoscopic salpingo-oophorectomy: A case report

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