A patient with bilateral immature ovarian teratoma presenting with paraneoplastic encephalitis

Background.Teratomas can be accompanied by a paraneoplastic syndrome with severe neurological and psychiatric manifestations or even death as a result. These symptoms mostly precede the gynecological diagnosis.Case.We present a case of a 32-year-old woman with paraneoplastic encephalitis. The gynecologic oncologist was consulted because of suspicion on a pelvic mass. Physical examination and transvaginal ultrasound (TVU) showed enlarged ovaries. Bilateral salpingo-oophorectomy and complete staging were performed resulting in FIGO stage Ib grade 1 immature teratoma. After surgery her neurological condition improved significantly.Conclusion.In case a young woman presents with encephalitis of unknown origin she should also be referred to the gynecologist to rule out ovarian pathology, especially since surgical removal of a teratoma may result in clinical improvement or even complete recovery.