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Mature Cystic Teratoma : Clinical Features

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CLINICAL PRESENTATION (continued from previous image):

Anti-N-methyl-D-aspartate (NMDA) Receptor Encephalitis: In rare cases of mature teratoma (predominantly in children and young adults), the exposure of mature brain tissue within the teratoma to the immune system leads to the formation of autoantibodies against NMDA receptors.

NMDA receptor is a glutamate receptor and an ion channel found in neurons of the brain. It is thought to be important for synaptic plasticity and in mediating learning and memory functions. Patients develop neurologic deficits and psychiatric symptoms of rapid onset which resolve following the removal of the teratoma.

About this image This 4.0 cm mature cystic teratoma is filled with greasy material (keratin and sebaceous secretions) and shows tufts of hair. The oval solid area at the bottom is called Rokitansky protruberance. Microscopically, it also showed foci of neural tissue. This case was discovered incidentally at the time of cesarean section. About 60% of cases are asymptomatic. Image courtesy of Ed Uthman, MD, Houston, Texas. Used with permission.

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