Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis associated with mature ovarian teratoma: a case report

Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is an autoimmune condition often characterized by acute neuropsychiatric manifestations, including psychiatric symptoms, seizures, autonomic instability, and cognitive dysfunction. Early diagnosis and treatment are crucial for improving patient outcomes. This report presents the case of a 27-year-old woman with known anti-NMDA receptor encephalitis who experienced progressive worsening of confusion, memory loss, and agitation. The patient was transferred to a tertiary care center for further evaluation and treatment. A computed tomography scan with contrast showed a 40 mm complex mass in the right adnexa, consistent with ovarian teratoma. The patient was hospitalized for 37 days, requiring immunotherapy, neurologic, psychiatric, cardiovascular, and operative management. The ovarian teratoma was successfully removed via robotic-assisted right salpingo-oophorectomy. This case underscores the importance of surgical management of ovarian teratoma in a reproductive-aged woman with anti-NMDA receptor encephalitis. A multidisciplinary approach should be employed, and individualized treatment should be tailored to the patient's clinical status. Optimal treatment strategies for anti-NMDA receptor encephalitis are lacking. Further research is needed.