摘要
Abstract
Objective:To investigate the clinical characteristics,diagnostic and therapeutic strategies and prog-nosis of ovarian teratoma complicated with anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis.Methods:The clinical data of 12 patients with ovarian teratoma complicated with anti-NMDAR encephalitis admitted to Shanxi Bethune Hospital from January 1,2011 to December 31,2024 were retrospectively analyzed,including gen-eral data,clinical manifestations,auxiliary examinations,treatment methods and follow-up results.Results:The average age of 12 patients was 27.58±7.98 years,with a predominance of young women;8 cases(66.7%)were aged 30 years or younger.11 cases(91.7%)presented with prodromal symptoms such as fever or headache,fol-lowed by rapid onset of typical manifestations such as psychiatric and behavioral abnormalities,and only 1 case presented directly with psychiatric abnormalities.Epilepsy was the most common manifestation in the course of disease(12 cases,100.0%).The incidence of psychiatric and behavioral abnormalities,disturbance of conscious-ness,and movement disorders were 91.7%,75.0%,and 66.7%,respectively.Imaging examination showed that the maximum diameter of cysts was less than 3.0 cm in 9 patients(75.0%),and bilateral lesions were found in 2 patients(16.7%).All patients underwent laparoscopic surgery,with complete tumor resection.Postoperative pa-thology confirmed mature teratoma in 11 cases and immature teratoma in 1 case.Regarding treatment,11 patients received first-line immunosuppressive therapy before surgery,while one underwent surgery directly,neuropsychi-atric symptoms were significantly improved after operation.The average follow-up time was 28 months.There was no recurrence or loss of follow-up,and 4 cases had mild emotional lability or memory decline postoperatively,but did not affect daily life.Conclusions:Ovarian teratoma complicated with anti-NMDAR encephalitis is more common in young women.The clinical manifestations are diverse and easy to be misdiagnosed in the early stage.Early iden-tification and timely surgical resection of the tumor are the key to improve the prognosis.Routine gynecological ul-trasound screening is reconmmended for women with unexplained psychiatric symptoms.关键词
抗N-甲基-D-天冬氨酸受体脑炎/卵巢畸胎瘤/副肿瘤综合征/癫痫/免疫抑制治疗Key words
Anti-N-methyl-D-aspartate receptor encephalitis/Ovarian teratoma/Paraneoplastic syndrome/Epilep-sy/Immunosuppressive therapy分类
医药卫生
