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[Associated tumors in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis]

Makoto Hara1, Akihiko Morita, Satoshi Kamei

  • 1Division of Neurology, Department of Medicine, Nihon University School of Medicine.

Rinsho Shinkeigaku = Clinical Neurology
|December 1, 2012
PubMed

Insights

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is increasingly diagnosed, with a declining frequency of associated tumors over time. However, tumor prevalence varies, and certain patient groups are less likely to have tumors.

Area of Science:

  • Neurology
  • Immunology
  • Oncology

Background:

  • Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis was first described in 2007, often associated with ovarian teratomas.
  • The reported frequency of associated tumors in NMDAR encephalitis has decreased over time, from 60% in 2008 to 42% in 2011.
  • Discrepancies in tumor frequency across studies suggest variability in patient populations and diagnostic criteria.

Purpose of the Study:

  • To analyze the changing frequency of paraneoplastic findings in anti-NMDAR encephalitis.
  • To investigate factors influencing the likelihood of tumor association in NMDAR encephalitis patients.
  • To report on non-ovarian tumors associated with NMDAR encephalitis and present a unique case.

Main Methods:

  • Review of published data on anti-NMDAR encephalitis and associated tumors.
  • Stratification analysis based on patient demographics (age, sex).
  • Case report of a patient with uterine carcinosarcoma and NMDAR encephalitis.

Main Results:

  • The frequency of tumor association in NMDAR encephalitis decreased from 60% (100 patients, 2008) to 42% (400 patients, 2011).
  • Younger patients (<18 years) and male patients were less likely to have associated tumors.
  • Non-ovarian tumors (e.g., breast cancer, small-cell lung carcinoma) were found in 2% of patients; a uterine carcinosarcoma case was identified.

Conclusions:

  • The prevalence of tumors in anti-NMDAR encephalitis has declined, though variations exist.
  • Patient age and sex are significant factors in the likelihood of tumor association.
  • The prognosis of NMDAR encephalitis may depend on the underlying malignancy.

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