Paraneoplastic neurological disorders in children with benign ovarian tumors

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

Research output: Contribution to journalArticle

10 Citations (Scopus)

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 18. years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5. years 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 10. years. 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.

Original languageEnglish
Pages (from-to)248-253
Number of pages6
JournalBrain and Development
Volume36
Issue number3
DOIs
Publication statusPublished - Mar 2014
Externally publishedYes

Fingerprint

Nervous System Diseases
Neoplasms
Ovary
Encephalitis
Immunotherapy
Mutism
Acute Disseminated Encephalomyelitis
Sialorrhea
Hypoventilation
Hallucinations
Teratoma
Rare Diseases
Vomiting
Headache
Seizures
Depression
Pathology

Keywords

  • Benign ovarian tumors
  • Children
  • Ovarian teratoma
  • Paraneoplastic encephalitis
  • Paraneoplastic neurological disorders

ASJC Scopus subject areas

  • Clinical Neurology
  • Developmental Neuroscience
  • Pediatrics, Perinatology, and Child Health

Cite this

Hsu, M. H., Huang, C. C., Hung, P. L., Huang, H. M., Huang, L. T., Huang, C. C., ... Chang, Y. C. (2014). Paraneoplastic neurological disorders in children with benign ovarian tumors. Brain and Development, 36(3), 248-253. https://doi.org/10.1016/j.braindev.2013.04.009

Paraneoplastic neurological disorders in children with benign ovarian tumors. / Hsu, Mei Hsin; Huang, Chao Ching; Hung, Pi Lien; Huang, Hsiu Mei; Huang, Li Tung; Huang, Chao Cheng; Sheen, Jiunn Ming; Huang, Song Chei; Chang, Ying Chao.

In: Brain and Development, Vol. 36, No. 3, 03.2014, p. 248-253.

Research output: Contribution to journalArticle

Hsu, MH, Huang, CC, Hung, PL, Huang, HM, Huang, LT, Huang, CC, Sheen, JM, Huang, SC & Chang, YC 2014, 'Paraneoplastic neurological disorders in children with benign ovarian tumors', Brain and Development, vol. 36, no. 3, pp. 248-253. https://doi.org/10.1016/j.braindev.2013.04.009
Hsu, Mei Hsin ; Huang, Chao Ching ; Hung, Pi Lien ; Huang, Hsiu Mei ; Huang, Li Tung ; Huang, Chao Cheng ; Sheen, Jiunn Ming ; Huang, Song Chei ; Chang, Ying Chao. / Paraneoplastic neurological disorders in children with benign ovarian tumors. In: Brain and Development. 2014 ; Vol. 36, No. 3. pp. 248-253.
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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 18. years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5. years 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 10. years. 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.",
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AU - Hung, Pi Lien

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AU - Huang, Chao Cheng

AU - Sheen, Jiunn Ming

AU - Huang, Song Chei

AU - Chang, Ying Chao

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N2 - 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 18. years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5. years 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 10. years. 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.

AB - 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 18. years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5. years 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 10. years. 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.

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