title: A patient with bilateral immature ovarian teratoma presenting with paraneoplastic encephalitis.
abstract: BACKGROUND
  Teratomas can be accompanied by a paraneoplastic syndrome with severe neurological and psychiatric manifestations or even death as a result. These symptoms mostly precede the gynecological diagnosis.
  
  
  METHODS
  We present a case of a 32-year-old woman with paraneoplastic encephalitis. The gynecologic oncologist was consulted because of suspicion on a pelvic mass. Physical examination and transvaginal ultrasound (TVU) showed enlarged ovaries. Bilateral salpingo-oophorectomy and complete staging were performed resulting in FIGO stage Ib grade 1 immature teratoma. After surgery her neurological condition improved significantly.
  
  
  CONCLUSIONS
  In case a young woman presents with encephalitis of unknown origin she should also be referred to the gynecologist to rule out ovarian pathology, especially since surgical removal of a teratoma may result in clinical improvement or even complete recovery.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. A.vanAltena@obgyn.umcn.nl
authors.forename: Anne M
authors.initials: AM
authors.lastname: van Altena
authors.forename: Geertruida J
authors.initials: GJ
authors.lastname: Wijnberg
authors.forename: Eva
authors.initials: E
authors.lastname: Kolwijck
authors.forename: Joanne A
authors.initials: JA
authors.lastname: de Hullu
authors.forename: Leon F A G
authors.initials: LF
authors.lastname: Massuger
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020363:Limbic Encephalitis / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D013724:Teratoma / Q000175:diagnosis*