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Neurology
Seronegative autoimmune encephalitis associated with ovarian teratoma and uterine STUMP tumour
  1. Christopher Niblock1,
  2. Abigail Richards1,
  3. Damodar Makkuni2 and
  4. Edward James Needham3
  1. 1 Accident and Emergency, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
  2. 2 Rheumatology Department, James Paget University Hospital, Norwich, UK
  3. 3 Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Christopher Niblock; christopher.niblock{at}jpaget.nhs.uk

Abstract

This case report details a case of probable seronegative autoimmune encephalitis (AE) secondary to either an ovarian teratoma or a uterine smooth muscle tumour of uncertain malignant potential (STUMP). AE is a neurological disorder often associated with specific autoantibodies. However, cases can occur without identifiable antibodies, necessitating a broader diagnostic approach. We present a woman in her 30s who exhibited sudden-onset acute behavioural disturbance and psychiatric symptoms. Initial investigations, including both infective and autoimmune screening, returned negative. Further investigations revealed an adnexal mass and raised ovarian tumour markers. Both an ovarian teratoma and a uterine STUMP were resected. Postoperatively, the patient demonstrated significant clinical improvement, with resolution of neurological symptoms and normalisation of cognitive function.

  • Autoimmunity
  • Gynecological cancer
  • Adult intensive care
  • Paraneoplastic Syndromes

https://doi.org/10.1136/bcr-2024-264045

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    Footnotes

    • Contributors All authors have been directly involved in the patient’s care and have been directly involved in the writing of this manuscript. DM was in charge of the care of the patient overall and is the guarantor. DM supervised the writing of the manuscript. EJN was in charge of the care of the patient while she was at Addenbrookes Hospital. EJN also supervised the writing of the manuscript and contributed significantly to the edits following the first draft. CN was involved in the care of the patient both in the emergency department and the intensive care unit. AR was involved in the care of the patient prior to her transfer to the intensive care unit and on repatriation back to James Paget University Hospital. CN and AR wrote the core content of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.