Open AccessParaneoplastic anti‐ N ‐methyl‐ d ‐aspartate receptor encephalitis: have you checked the ovaries?
Author(s) -
Cleverly Kirsty,
Gambadauro Pietro,
Navaratnarajah Ramesan
Publication year - 2014
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12386
Subject(s) - medicine , ovarian teratoma , oophorectomy , cystectomy , teratoma , lesion , encephalitis , laparoscopy , surgery , gynecology , hysterectomy , virus , bladder cancer , cancer , immunology
Anti‐ N ‐methyl‐ d ‐aspartate receptor encephalitis is an autoimmune disorder that can occur as a paraneoplastic phenomenon related to ovarian teratomas. It is a serious but reversible condition with improved outcomes following prompt tumor removal. We report two cases from our recent experience. In the first case a small poorly described lesion, confirmed as a teratoma only at histology, was managed by laparoscopic oopohorectomy. In the second case a large teratoma was managed by laparoscopic cystectomy. Postoperatively both women made a good recovery. Gynecologists may be called upon to perform ovarian surgery outside of normal surgical indications, in young women who will often lack capacity to consent. Fertility‐sparing ovarian cystectomy is possible in some cases, but will be challenging for small deeply buried tumors. Blind bilateral oophorectomy has been performed successfully in extreme cases. Information of the benefit of ovarian surgery will be essential to the surgeon during preoperative counseling.