Abstract
Background
Anti-NMDA-R receptor encephalitis occurs predominantly in younger women and is often
comorbid with ovarian teratoma, a feature that is often absent in children. Here,
we report our experience with two pediatric patients, in whom no tumors were present
during treatment for encephalitis, but in whom ovarian teratomas developed without
encephalitis relapse after treatment was completed.
Cases
Patient 1 was a 14-year-old girl who was diagnosed due to characteristic symptoms
and anti-NMDA-R antibody. MRI scanning during treatment revealed no ovarian tumors,
but a tumor developed in the right ovary 10 months after onset. Another tumor developed in the left ovary 3 years after onset, and a mature ovarian teratoma was confirmed after bilateral partial
ovariectomy. Patient 2 was an 11-year old girl who was also diagnosed due to characteristic
symptoms and anti-NMDA-R antibody. Imaging during treatment revealed no ovarian tumors,
but a 2.5-cm tumor mass was found in the left ovary 10 months after onset, and a mature ovarian teratoma was confirmed after partial ovariectomy.
Discussion
This case report suggests the need for regular tumor screening after treatment for
anti-NMDA receptor encephalitis because of potential subsequent tumor development,
even in pediatric patients who initially present with no comorbid tumors. No analysis
of relapse risk has yet been reported in cases of tumor development after treatment,
and at this point, whether or not resection is needed to prevent relapse remains unclear.
However, because teratomas usually grow, have an associated risk of torsion, and can
be malignant, tumor removal should be considered.
Keywords
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References
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Article info
Publication history
Published online: December 28, 2016
Accepted:
December 13,
2016
Received in revised form:
December 6,
2016
Received:
August 29,
2016
Identification
Copyright
© 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
