In women of childbearing age with NMDA encephalitis and normal pelvic imaging, is there a role for oophorectomy for possible microteratoma?

Pelvic imaging of female patients with anti-NMDA-receptor encephalitis for ovarian teratoma should consist of MRI of pelvis or ultrasound of pelvis with transvaginal views. If this testing is unrevealing, the recommendation, in general, is not to proceed with oophorectomy. There have been reports of microteratoma in some ovaries removed in this context. However, there is no proven clinical benefit to removing the ovaries in the setting of negative imaging. The main point of emphasis is to treat early and aggressively with immune therapy in all patients with anti-NMDA-receptor encephalitis. Rescreening for ovarian teratoma could be considered in those patients refractory to immune therapy. For patients >40 years, a broader screening strategy...