Anti-NMDAR encephalitis with ovarian teratomas: Review of the literature and two case reports

Chiu, Hsiao-Chen; Su, Yu-Ching; Huang, Su-Cheng; Chiang, Han‐Lin; Huang, Pei-Shen

doi:10.1016/j.tjog.2019.03.004

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…2,7 Neuroglial elements are possibly more commonly detected in NMDARE versus non-NMDARE ovarian teratomas, as our data trended toward significance and as discussed in a small case-control study. 8 We also found that teratoma volumes are smaller in NMDARE versus non-NMDARE, which is most likely due to earlier tumor detection, similar to how neuroblastomas are detected earlier in opsoclonus myoclonus ataxia syndrome 9 due to a paraneoplastic response to the tumor.…”

Section: Discussionsupporting

confidence: 66%

Rate of Anti-NMDA Receptor Encephalitis in Ovarian Teratomas

Milla

Gombolay

2021

Neuropediatrics

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Background The rate of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) in ovarian teratomas is unknown. We aim to identify the prevalence of NMDARE as well as volumetric and histopathologic characteristics of ovarian teratomas in patients with versus without. Methods We performed a retrospective cohort study to identify patients with confirmed ovarian teratomas and the characteristics of teratomas in NMDARE compared with non-NMDARE patients. Patients aged between 0 and 21 years with confirmed histopathological diagnosis of ovarian teratoma after resection were included. The rate of NMDARE in ovarian teratomas was identified. Moreover, volumes of ovarian teratomas and the frequency of neuronal glial elements on histopathology in NMDARE versus non-NMDARE patients were assessed. Results Five out of one-hundred-and-sixty-three (3.07%) patients with histopathology confirmed ovarian teratomas were diagnosed with NMDARE. Age was not different between the NMDARE (mean: 13.8 years, standard deviation: 3.9) and non-NMDARE groups (median: 14, interquartile range [IQR]: 5). Teratoma volumes from NMDARE patients were smaller than those of non-NMDARE patients (median 28.3 cm3 with IQR of 431.2 and median 182.8 with IQR of 635.0, respectively). Both age and NMDARE diagnosis were statistically significant variables in the analysis of variance on a multiple linear regression model. Age (p = 0.013) had a positive correlation with teratoma size, whereas presence of NMDARE had a negative correlation (p = 0.008). Conclusion The rate of NMDARE in ovarian teratomas is low and NMDARE patients have smaller teratomas than non-NMDARE. Further studies are needed to understand the timing of anti-NMDA receptor antibodies in teratomas and the development of NMDARE.

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Section: Discussionsupporting

confidence: 66%

Rate of Anti-NMDA Receptor Encephalitis in Ovarian Teratomas

Milla

Gombolay

2021

Neuropediatrics

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“…In Taiwan, an article reviewing 13 female anti-NMDAR encephalitis patients from 2011 to 2018 disclosed the time to correct diagnosis ranged from 7 to 150 days, and time to hospitalization ranged from 37 to 210 days ( Chiu et al., 2019 ). In our case, the time to diagnosis of anti-NMDAR encephalitis was around 21 days.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune psychosis in Taiwan: A case report and review of literature

Guu

Tsai

2020

Brain, Behavior, & Immunity - Health

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“…Additionally, some patients with mature teratoma may present with N-methyl-d-aspartate (NMDA) encephalitis, which is a rarely seen but severe neurological disorder [ 41 ]. Several studies showed that young women or children with ovarian teratoma could be affected by encephalitis, which leads to a wide range of neuropsychiatric symptoms such as psychosis, memory loss, and behavior disorder and subsequently develops into seizures, dyskinesias, and autonomic instability [ 42 , 43 , 44 , 45 , 46 , 47 ]. The majority of the teratomas are mature, while the other third are immature.…”

Section: Clinical Symptomsmentioning

confidence: 99%

Mature Cystic Teratoma: An Integrated Review

Cong

Wang

Yeung

et al. 2023

IJMS

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Ovarian dermoid cysts, also called mature cystic teratomas (MCTs), account for 69% of ovarian germ cell tumors in young women. The tumors are formed by tissues derived from three germ layers, and sebaceous materials are most commonly seen. The origin of MCTs is widely considered to be the germ cell origin, which completes meiosis I. The clinical symptoms vary widely, but 20% of tumors could be asymptomatic. The diagnosis of MCTs is usually made without difficulty by ultrasound and confirmed by histopathology post-operatively. The imaging findings have a high diagnostic value. The typical characteristics present in the sonographic images, including a dermoid plug or Rokitansky nodule, are considered strong evidence for a teratoma. Although the malignant transformation of MCTs is rare, it can occur in some cases, especially in women of advanced age. The treatment of MCTs depends on the risk of malignancy, the age of the patient, and the patient’s fertility reserve requirement. In this article, we review the epidemiology, clinical symptoms, diagnosis criteria, cellular origin, and treatment of mature cystic teratomas.

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Anti-NMDAR encephalitis with ovarian teratomas: Review of the literature and two case reports

Cited by 13 publications

References 12 publications

Rate of Anti-NMDA Receptor Encephalitis in Ovarian Teratomas

Rate of Anti-NMDA Receptor Encephalitis in Ovarian Teratomas

Autoimmune psychosis in Taiwan: A case report and review of literature

Mature Cystic Teratoma: An Integrated Review

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