title: Successful Laparoscopic Resection of 7 mm Ovarian Mature Cystic Teratoma Associated with Anti-NMDAR Encephalitis.
abstract: Anti-NMDAR (N-methyl-D-aspartate receptor) encephalitis is an immune-mediated encephalitis. It has been predominantly described in young women and is commonly associated with an ovarian teratoma. We report a case of anti-NMDAR encephalitis associated with a 7 mm ovarian teratoma that was completely resected by laparoscopic surgery. An 18-year-old woman suddenly presented with personality changes requiring her admission to the department of neurology. After that, she also showed involuntary movements, disturbance of consciousness, and central hypoventilation. As an abdominal image revealed the possibility of a right ovarian teratoma of 5 × 7 mm, a laparoscopic operation was performed. The macroscopic appearance of the right ovary did not show any abnormalities; nevertheless, we performed a partial resection of the right ovary, with reference to the image diagnosis, in order to spare the ovarian reserve. The 22 × 22 mm partially resected ovary contained an intact 5 × 7 mm cystic tumor. The pathological diagnosis was mature cystic teratoma with components of brain tissue. An anti-NMDAR-antibody test proved positive in both serum and cerebrospinal fluid 1 month after the surgery. From these results, she was diagnosed with anti-NMDAR encephalitis. By the administration of cyclophosphamide in addition to the operation, she recovered drastically without any of the symptoms shown before.
authors: Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo 006-8555, Japan ; Department of Obstetrics and Gynecology, Dokkyo Medical University, Tochigi, Japan.
authors: Masaru
authors: 0000-0002-2328-1146
authors: M
authors: Hayashi
authors: Department of Obstetrics and Gynecology, Dokkyo Medical University, Tochigi, Japan.
authors: Emi
authors: 0000-0002-2320-1329
authors: E
authors: Motegi
authors: Department of Anatomic and Diagnostic Pathology, Dokkyo Medical University, Tochigi, Japan.
authors: Koichi
authors: K
authors: Honma
authors: Department of Anatomic and Diagnostic Pathology, Dokkyo Medical University, Tochigi, Japan.
authors: Nobuhide
authors: N
authors: Masawa
authors: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors: Hideki
authors: H
authors: Sakuta
authors: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors: Koichi
authors: K
authors: Hirata
authors: Department of Radiology, Dokkyo Medical University, Tochigi, Japan.
authors: Yasushi
authors: Y
authors: Kaji
authors: Department of Obstetrics and Gynecology, Dokkyo Medical University, Tochigi, Japan.
authors: Ichio
authors: 0000-0002-5978-0713
authors: I
authors: Fukasawa