My OBGYN wife would like to know if she had a mature cystic teratoma (that she classifies as benign) or an immature teratoma (which she says is rare). I told her ER docs only really chapter 1 of every topic and that certainly sounds like chapter 5, but hopefully you can help. Thx!
I have the question out to Sol and will let you know if he is able to find out. As much as it is an esoteric question in some ways, I do think it might be nice to know if nearly all of them are mature or nearly all are immature- in terms of talking to family about prognosis. I found a review (auth: Pedro Acien) in which mature teratomas accounted for 57% of all patients with NMDA-R encephalitis (74% of those in whom a teratoma was found) and immature accounted for 16.7% of all patients (21.6% of those with teratoma). It seems like immature teratomas accounted for a disproportionate number compared to their rarity, but still the vast minority. This was not specifically a peds study, but the ave age was ~24 years of age for NMDA-R encephalitis patients with teratoma, so not too far from a pediatric study! Hope that is helpful and I will let you know if I get the final on this particular patient.
Thank you for covering this topic. If it weren't for EMRAP I would not have known this information and would not have started a pt down this w/u path in early December 2020. This was the diagnosis and he is getting better because of your knowledge shared. What you do matters.
That's so good to hear! As many times as I hear about an uncommon diagnosis, it's still hard to think of it at the right time, and have the confidence to pursue the diagnosis. Fortunate for the patient that you did!
I also would like to thank you for covering this. Recently a colleague had a puzzling 9 year old patient come back to ER the same days with odd cognitive symptoms and memory loss for being in ER earlier in the day. It sounded like it could be NMDA encephalitis and told her check for that and it turned out to be NMDA encephalitis.
Shawn S. - December 1, 2020 6:40 PM
My OBGYN wife would like to know if she had a mature cystic teratoma (that she classifies as benign) or an immature teratoma (which she says is rare). I told her ER docs only really chapter 1 of every topic and that certainly sounds like chapter 5, but hopefully you can help. Thx!
ilene c. - December 1, 2020 9:48 PM
I have the question out to Sol and will let you know if he is able to find out. As much as it is an esoteric question in some ways, I do think it might be nice to know if nearly all of them are mature or nearly all are immature- in terms of talking to family about prognosis. I found a review (auth: Pedro Acien) in which mature teratomas accounted for 57% of all patients with NMDA-R encephalitis (74% of those in whom a teratoma was found) and immature accounted for 16.7% of all patients (21.6% of those with teratoma). It seems like immature teratomas accounted for a disproportionate number compared to their rarity, but still the vast minority. This was not specifically a peds study, but the ave age was ~24 years of age for NMDA-R encephalitis patients with teratoma, so not too far from a pediatric study! Hope that is helpful and I will let you know if I get the final on this particular patient.
Darren M. - December 23, 2020 1:28 PM
Thank you for covering this topic. If it weren't for EMRAP I would not have known this information and would not have started a pt down this w/u path in early December 2020. This was the diagnosis and he is getting better because of your knowledge shared. What you do matters.
ilene c. - December 24, 2020 4:33 PM
That's so good to hear! As many times as I hear about an uncommon diagnosis, it's still hard to think of it at the right time, and have the confidence to pursue the diagnosis. Fortunate for the patient that you did!
John A. - April 30, 2021 8:11 AM
I also would like to thank you for covering this. Recently a colleague had a puzzling 9 year old patient come back to ER the same days with odd cognitive symptoms and memory loss for being in ER earlier in the day. It sounded like it could be NMDA encephalitis and told her check for that and it turned out to be NMDA encephalitis.
ilene c. - April 30, 2021 3:43 PM
That's amazing! Thanks for sharing