Rinsho Shinkeigaku (Clinical Neurology)

Symposium 1

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

Makoto Hara, M.D., Akihiko Morita, M.D. and Satoshi Kamei, M.D.

Division of Neurology, Department of Medicine, Nihon University School of Medicine

In 2007, Dalmau and colleagues described anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis associated with ovarian teratoma. As the numbers of patients with anti-NMDAR encephalitis increased, the frequency of paraneoplastic findings declined. The frequency of anti-NMDAR encephalitis with the tumor declined to 60% of a total of 100 patients in 2008, and 42% of a total of 400 patients in 2011. This 42% was the similar value as the tumor frequency in Acute Juvenile Female Non-Herpetic Encephalitis in Japan. It was also revealed that the discrepancies in tumor frequency of anti-NMDAR encephalitis between investigations existed. The results of stratification analyses of anti-NMDAR encephalitis revealed that patients who were younger than 18 years old and male patients with anti-NMDAR encephalitis were less likely to have associated tumors. Dalmau also reported tumors other than ovarian tumors were associated with 2% (9/400) of patients in 2011. These patients included breast cancer, neuroendocrine tumors, pancreatic carcinoma, sex cord stromal tumors, testicular germ-cell tumors and small-cell lung carcinoma. We encountered a 65-year-old female affected by anti-NMDAR encephalitis with carcinosarcoma with neuroendocrine differentiation of the uterus. The prognosis of anti-NMDAR encephalitis with malignant tumor could be dependent on the prognosis of the associated tumor.
Full Text of this Article in Japanese PDF (166K)

(CLINICA NEUROL, 52: 979|981, 2012)
key words: anti-N-methyl-D-aspartate receptor encephalitis, ovarian teratoma, malignant tumor, frequency

(Received: 23-May-12)