Hematology, Hangzhou Children's Hospital, Hang-zhou, Zhe-jiang, China
Department of Children's Hematology, Hangzhou Children's Hospital, Hang-zhou, Zhe-jiang, China.
BMJ Case Rep. 2023 Oct 29;16(10):e256807. doi: 10.1136/bcr-2023-256807.
In young women with anti-N-methyl-D-aspartate receptor (anti-NMDAR) autoimmune encephalitis (AE), co-occurrence with ovarian teratoma is common. While the management of mature teratoma with AE is well documented, literature on managing immature teratoma (IT) in tandem with AE is relatively scarce. Here, we report a case of a female patient in her early adolescence who presented with abdominal pain and was diagnosed with grade 3 IT combined with anti-NMDAR AE after an ovarian tumour was discovered and resected. Postsurgery, the patient received immunotherapy, chemotherapy and antiepileptic therapy, and two follow-up evaluations showed no signs of recurrence or sequelae. This case highlights the importance of a high index of suspicion for concurrent AE in the presence of ovarian teratoma, particularly IT, and the crucial role of concurrent administration of immunotherapy and chemotherapy following tumour resection in impacting prognosis.
在患有抗 N-甲基-D-天冬氨酸受体（抗 NMDAR）自身免疫性脑炎（AE）的年轻女性中，常合并卵巢畸胎瘤。虽然有大量关于抗 NMDAR AE 合并成熟畸胎瘤的管理的文献，但关于抗 NMDAR AE 合并未成熟畸胎瘤（IT）的管理的文献相对较少。在这里，我们报告了一例青春期早期女性患者，因发现卵巢肿瘤并切除后出现腹痛，被诊断为 3 级 IT 合并抗 NMDAR AE。术后，患者接受了免疫治疗、化疗和抗癫痫治疗，两次随访评估均未发现复发或后遗症。本病例强调了在存在卵巢畸胎瘤、特别是 IT 的情况下，对并发 AE 保持高度警惕的重要性，以及肿瘤切除后同时进行免疫治疗和化疗对影响预后的关键作用。
