Skip to main content
SpringerLink
Log in

‘Benign’ ovarian teratoma and N-methyl-D-aspartate receptor (NMDAR) encephalitis in a child

  • Case Report
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

N-methyl-D-aspartate receptor (NMDAR) encephalitis is a life-threatening paraneoplastic neuropsychiatric encephalitis that predominantly affects young women and has a strong association with ovarian teratomas. Removal of the ovarian teratomas improves the prognosis and decreases the risk of recurrence. We present an 11-year-old girl with NMDAR encephalitis with small bilateral teratomas not initially appreciated on abdominal CT or pelvic MRI. A 12-mm teratoma was identified in the right ovary and a 7-mm teratoma was identified in the left ovary on US follow-up at 5 months. Intraoperative sonography was used to localize the teratomas for excision. In NMDAR encephalitis, the ovarian teratomas can be very small, particularly in children, and easily missed on cross-sectional imaging. Awareness of the association of NMDAR encephalitis and ovarian teratomas will improve the diagnostic accuracy and imaging interpretation. Periodic sonography and MRI might be warranted in children if the initial study is negative.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Vitaliani R, Mason W, Ances B et al (2005) Paraneoplastic encephalitis, psychiatric symptoms, and hypoventilation in ovarian teratoma. Ann Neurol 58:594–604

    Article  PubMed  Google Scholar 

  2. Dalmau J, Tüzün E, Wu HY et al (2007) Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol 61:25–36

    Article  PubMed  CAS  Google Scholar 

  3. Dalmau J, Gleichman AJ, Hughes EG et al (2008) Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol 7:1091–1098

    Article  PubMed  CAS  Google Scholar 

  4. Florance NR, Davis RL, Lam C et al (2009) Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in children and adolescents. Ann Neurol 66:11–18

    Article  PubMed  Google Scholar 

  5. Iizuka T, Sakai F, Ide T et al (2008) Anti-NMDA receptor encephalitis in Japan: long-term outcome without tumor removal. Neurology 70:504–511

    Article  PubMed  CAS  Google Scholar 

  6. Irani SR, Bera K, Waters P et al (2010) N-methyl-D-aspartate antibody encephalitis: temporal progression of clinical and paraclinical observations in a predominantly non-paraneoplastic disorder of both sexes. Brain 133:1655–1667

    Article  PubMed  Google Scholar 

  7. Prüss H, Dalmau J, Harms L et al (2010) Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology 75:1735–1739

    Article  PubMed  Google Scholar 

  8. Greiner H, Leach JL, Lee KH et al (2011) Anti-NMDA receptor encephalitis presenting with imaging findings and clinical features mimicking Rasmussen syndrome. Seizure 20:266–270

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Kieran J. Frawley

    Present address: Department of Radiology, Royal Children’s Hospital, Herston Road, Brisbane, Qld, 4029, Australia

Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Kieran J. Frawley & Maria A. Calvo-Garcia

  2. Department of Pediatrics, Division of Child Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Darcy A. Krueger

  3. Department of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Richard L. McMasters

Authors
  1. Kieran J. Frawley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria A. Calvo-Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Darcy A. Krueger
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Richard L. McMasters
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kieran J. Frawley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Frawley, K.J., Calvo-Garcia, M.A., Krueger, D.A. et al. ‘Benign’ ovarian teratoma and N-methyl-D-aspartate receptor (NMDAR) encephalitis in a child. Pediatr Radiol 42, 120–123 (2012). https://doi.org/10.1007/s00247-011-2111-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-011-2111-6

Keywords

Search

Navigation