Paraneoplastic neurological disorders in children with benign ovarian tumors.

Abstract

AIM:

Paraneoplastic neurological diseases (PND) are rare, but potentially treatable disorders. Paraneoplastic encephalitis is rapidly emerging as an important but likely under-recognized condition in children. The aim of this study was to assess the prevalence and spectrum of PND in children with benign ovary tumor and the long-term outcome.

PATIENTS AND METHODS:

We retrospectively reviewed the charts of all female patients below 18years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5years of tumor diagnosis and the related investigations were recorded.

RESULTS:

There were total 133 children and adolescents with benign ovarian tumors, mostly mature teratoma. Six patients (4.5%) had neuropsychiatric manifestations and all but one were beyond age 10years. The most common neuropsychiatric presentations were depression or low mood (84%), headache (50%), mutism (50%), hypoventilation (50%), seizures (30%), hallucination (30%), vomiting and hypersalivation (30%). Three patients (2.2%) had serious PND including acute disseminated encephalomyelitis in 1 and anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in 2. Although all of three improved after tumor removal, one without immunotherapy had neurological sequelae and prolonged ICU stay.

CONCLUSION:

The prevalence of PND in benign ovary tumor is not so uncommon in children. It is important to survey ovary tumors in female adolescents with subacute presentation of multiple-level involvement of neuraxis where no clear alternate diagnosis is possible. Treatment of serious PND associated with ovary tumors should include immunotherapy in addition to tumor removal.

• Authors: Mei-Hsin Hsu, Chao-Ching Huang, Pi-Lien Hung, Hsiu-Mei Huang, Li-Tung Huang, Chao-Cheng Huang, Jiunn-Ming Sheen, Song-Chei Huang, Ying-Chao Chang
• Journal: Brain & development (Brain Dev) Vol. 36 Issue 3 Pg. 248-53 (Mar 2014) ISSN: 1872-7131 [Electronic] Netherlands
• PMID: 23694758 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Brain (pathology)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Magnetic Resonance Imaging
• Mental Disorders (diagnosis, epidemiology)
• Ovarian Neoplasms (diagnosis, epidemiology, pathology, therapy)
• Paraneoplastic Syndromes, Nervous System (diagnosis, epidemiology, pathology, therapy)
• Prevalence
• Prognosis
• Retrospective Studies
• Spinal Cord (pathology)
• Teratoma (diagnosis, epidemiology, pathology, therapy)
• Tomography, X-Ray Computed
• Treatment Outcome