Early Ovarian Teratoma Resection Improves Outcomes in Anti–N-Methyl-D-Aspartate Receptor Encephalitis: A Dual-Case Series

Objective: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a neuroimmune disorder closely associated with ovarian teratomas, yet the prognostic impact of early surgical intervention requires further exploration. This dual-case analysis highlights the critical role of timely teratoma resection in improving clinical outcomes. Case Presentation: Case 1 involved a 34-year-old female presenting with psychiatric-dominant symptoms. A right salpingo-oophorectomy (pathology: immature teratoma) was performed 18 days post-onset, followed by rituximab therapy, resulting in full recovery with a modified Rankin Scale (mRS) score of 0. Case 2, a 16-year-old adolescent, underwent an initial laparoscopic ovarian teratoma resection (pathology: mature teratoma) 28 days post-onset. Residual tumor necessitated a second surgery (on day 95), leaving mild quadriparesis and ataxia with a mRS score of 2. Both cases remained recurrence-free during follow-up (17 and 14 months, respectively). Conclusion: Early surgical resection of ovarian teratomas is critical for favorable prognosis in anti-NMDAR encephalitis, halting antibody production and preventing irreversible neurological damage.