Hattori Yukio, Yamashita Yoriko, Mizuno Masayuki, Katano Kinue, Sugiura-Ogasawara Mayumi, Matsukawa Noriyuki
Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
J Obstet Gynaecol Res. 2017 Feb;43(2):412-415. doi: 10.1111/jog.13221.
Anti-N-methyl-d-aspartate receptor (NMDAR) limbic encephalitis is the most common form of paraneoplastic encephalitis that is associated with teratomas. Because tumor removal leads to better clinical outcomes, it is essential to reveal the location of the teratomas. This is the first reported case of anti-NMDAR encephalitis associated with teratoma of the fallopian tube. Salpingo-oophorectomy improved neurological symptoms and immunohistochemical examinations indicated the expression of NMDAR on neuroglial cells within the fallopian tube teratoma. Teratomas of the fallopian tube cause anti-NMDAR encephalitis; the imaging analysis and exploratory laparoscopies of the fallopian tube as well as of the ovary should be considered. Surgical removal of both fallopian tubes and ovaries with a normal appearance should be considered for patients in whom immunotherapy is not effective.
抗N-甲基-D-天冬氨酸受体（NMDAR）边缘叶脑炎是与畸胎瘤相关的最常见的副肿瘤性脑炎形式。由于肿瘤切除可带来更好的临床结果，因此明确畸胎瘤的位置至关重要。这是首例报告的与输卵管畸胎瘤相关的抗NMDAR脑炎病例。输卵管卵巢切除术改善了神经症状，免疫组化检查显示输卵管畸胎瘤内神经胶质细胞上有NMDAR表达。输卵管畸胎瘤可导致抗NMDAR脑炎；应考虑对输卵管以及卵巢进行影像学分析和探索性腹腔镜检查。对于免疫治疗无效的患者，应考虑手术切除外观正常的双侧输卵管和卵巢。
