| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc |
| Journal website http://www.journalmc.org |
Case Report
Volume 8, Number 2, February 2017, pages 52-57
Remove the Ovarian Tumor, Cure the Encephalitis: Anti-NMDAR Encephalitis With Ovarian Teratoma in a Tertiary Hospital in Singapore
Table
| Case 1 | Case 2 | Case 3 | Case 4 | Summary | |
|---|---|---|---|---|---|
| Age (years) | 22 | 31 | 26 | 31 | 27.5 (mean) |
| Prodromal symptoms | Y | N | N | N | 1/4 |
| Seizures | Y | Y | N | N | 2/4 |
| Dyskinesia | Y | Y | N | Y | 3/4 |
| Dysautonomia | N | N | N | Y | 1/4 |
| EEG abnormality | Y | Y | Y | N | 3/4 |
| MRI brain abnormality | N | N | N | Y | 1/4 |
| Ovarian pathology seen on CT | N | N | Not done | N | 3/3 |
| Size of tumor seen on US (cm) | 5.1 | 1 | 3.8 | 8.1 | |
| Time from symptom onset to surgery (days) | 37 | 8 | 7 | 28 | 20 (mean) |
| Anti-NMDAR titer pre-surgery, serum | 1:100 | 1:32 | 1:32 | Not quantified | |
| Anti-NMDAR titer pre-surgery, CSF | 1:10 | 1:100 | 1:10 | Not quantified | |
| Type of surgery | Laparotomy ovarian cystectomy | Laparotomy ovarian cystectomy | Laparoscopic ovarian cystectomy | Laparotomy unilateral salpingo-oophorectomy | |
| Size of tumor, intraoperative (cm) | 2 | 1 | 4 | 5 | |
| Frozen section result | Benign | Benign | Not performed | Benign | |
| Final histology | Malignant | Malignant | Benign | Malignant | |
| Intravenous steroid | Y | Y | Y | Y | 4/4 |
| IVIG | N | Y | N | Y | 2/4 |
| Second line immunosuppressants | N | Y | N | Y | 2/4 |
| Adjuvant chemotherapy | N | N | N | Y | 1/4 |
| Response to treatment | Full recovery | Partial recovery | Full recovery | Full recovery | 3/4 |