부산대학교 도서관

Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is non-herpetic limbic encephalitis occurring primarily in young women. Here we report the case of anti-NMDA receptor encephalitis associated with a mature cystic ovarian teratoma, which was difficult to treatment. The patient was a 14-year-old female who developed encephalitis after the onset of symptoms of common cold. MRI showed right tubo-ovarian cyst. She was positive for anti-NMDA receptor antibody, and laparoscopic right tubo-ovarian cystectomy was performed. There were no histopathological findings of teratoma in the excised specimen. Her consciousness disorder did not improve, and her condition was resistant to treatment. Pelvic MRI performed four months after the initial surgery revealed a mass suspected to be a mature cystic teratoma in the left ovary, which was not observed on MRI performed before the initial surgery. Subsequently, laparoscopic left salpingo-oophorectomy was performed, and the pathological diagnosis was a mature cystic teratoma. Postoperatively, her consciousness level gradually improved, and she was discharged on postoperative day 37. She has been under outpatient observation since discharge, and no recurrence of encephalitis has been noted. Anti-NMDA receptor encephalitis can be associated with a small-sized teratoma; therefore, detailed image inspection should be frequently repeated if the patient’s condition does not improve after treatment. [Adv Obstet Gynecol, 71(1) : 45-50, 2019 (H31.2)]