Department of Obstetrics and Gynaecology, The Royal London Hospital, Bart's Health NHS Trust, London, UK.
Acta Obstet Gynecol Scand. 2014 Jul;93(7):712-5. doi: 10.1111/aogs.12386. Epub 2014 Apr 29.
Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune disorder that can occur as a paraneoplastic phenomenon related to ovarian teratomas. It is a serious but reversible condition with improved outcomes following prompt tumor removal. We report two cases from our recent experience. In the first case a small poorly described lesion, confirmed as a teratoma only at histology, was managed by laparoscopic oopohorectomy. In the second case a large teratoma was managed by laparoscopic cystectomy. Postoperatively both women made a good recovery. Gynecologists may be called upon to perform ovarian surgery outside of normal surgical indications, in young women who will often lack capacity to consent. Fertility-sparing ovarian cystectomy is possible in some cases, but will be challenging for small deeply buried tumors. Blind bilateral oophorectomy has been performed successfully in extreme cases. Information of the benefit of ovarian surgery will be essential to the surgeon during preoperative counseling.
抗 N-甲基-D-天冬氨酸受体脑炎是一种自身免疫性疾病，可作为与卵巢畸胎瘤相关的副肿瘤现象发生。这是一种严重但可逆转的疾病，如果及时切除肿瘤，预后会有所改善。我们报告了最近的两例病例。在第一个病例中，一个小而描述不明确的病变，仅在组织学上确认为畸胎瘤，通过腹腔镜卵巢切除术进行了治疗。在第二个病例中，一个大的畸胎瘤通过腹腔镜囊肿切除术进行了治疗。术后，两名女性都恢复良好。妇科医生可能需要在正常手术指征之外为年轻女性进行卵巢手术，而这些女性通常缺乏同意的能力。在某些情况下可以进行保留生育能力的卵巢囊肿切除术，但对于深埋的小肿瘤来说，这将是具有挑战性的。在极端情况下，已经成功地进行了盲目双侧卵巢切除术。在术前咨询期间，有关卵巢手术益处的信息对外科医生来说至关重要。
