Racial and Ethnic Disparities in the Incidence of Anti-NMDA Receptor Encephalitis.

OBJECTIVES: To estimate the incidence of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. METHODS: We conducted a retrospective cohort study of >10 million person-years of observation from members of Kaiser Permanente Southern California, 2011-2022. The electronic health record of individuals with text-string mention of NMDA and encephalitis were reviewed to identify persons who met diagnostic criteria for anti-NMDAR encephalitis. Age-standardized and sex-standardized incidences stratified by race and ethnicity were estimated according to the 2020 US Census population. RESULTS: We identified 70 patients who met diagnostic criteria for anti-NMDAR encephalitis. The median age at onset was 23.7 years (IQR = 14.2-31.0 years), and 45 (64%) were female patients. The age-standardized and sex-standardized incidence of anti-NMDAR encephalitis per 1 million person-years was significantly higher in Black (2.94, 95% CI 1.27-4.61), Hispanic (2.17, 95% CI 1.51-2.83), and Asian/Pacific Island persons (2.02, 95% CI 0.77-3.28) compared with White persons (0.40, 95% CI 0.08-0.72). Ovarian teratomas were found in 58.3% of Black female individuals and 10%-28.6% in other groups. DISCUSSION: Anti-NMDA receptor encephalitis disproportionately affected Black, Hispanic, or Asian/Pacific Island persons. Ovarian teratomas were a particularly common trigger in Black female individuals. Future research should seek to identify environmental and biological risk factors that disproportionately affect minoritized individuals residing in the United States.

Distinctive pattern of left-right asymmetry of ovarian benign teratomas in Chinese population: a 12-year-long cross-sectional study.

PURPOSE: Given the lack of research on the left-right asymmetry of ovarian teratoma among Chinese patients, this study aimed to determine the lateral distribution and related clinical characteristics of Chinese ovarian teratoma patients treated at a single center. METHODS: We conducted a cross-sectional study of surgical patients pathologically diagnosed with ovarian teratomas in the gynecology inpatient department of the International Peace Maternity and Child Health Hospital in Shanghai between July 2006 and July 2018. RESULTS: Of the 4417 patients with ovarian teratoma, 3835 were finally analyzed. There were 2030 (53.24%) cases of right-sided benign ovarian teratoma versus 1783 (46.76%) cases of left-sided benign teratoma (P < 0.001). The recurrence rate of benign ovarian teratoma was 4.2%; recurrence occurred more often on the left side (left vs. right = 55 vs. 45%, P = 0.033). Compared with the right-sided ovarian teratoma patients, left-sided ones had significantly high recurrence risk (OR 1.430; 95% CI 1.03-1.99). The rate of ovarian torsion in patients with ovarian mature cystic teratomas (MCTs) during intrauterine pregnancy was 3.17 versus 1.72% in non-pregnant MCT patients (P = 0.049). For those MCT patients with intrauterine pregnancy, ovarian torsion occurs more often on the right side (left vs. right = 16.67 vs. 83.33%, P = 0.028). CONCLUSION: This study confirms a distinctive right-side dominance of benign ovarian teratomas. Compared with the right side, recurrent ovarian teratomas occur more often on the left side, requiring close follow-up. Intrauterine pregnancy may increase the risk of ovarian torsion, particularly on the right side, in MCT patients.

The influence of age and other prognostic factors associated with survival of ovarian immature teratoma - A study of 1307 patients.

OBJECTIVE: To determine impact of age and other prognostic factors on the survival of ovarian immature teratoma (IT) patients. METHODS: Data obtained from the SEER database between 1973 and 2012. Kaplan-Meier methods and multivariate Cox regression models were used for statistical analyses. RESULTS: Of 1307 patients (median: 24years; range: 0-93), 78%, 5%, 13%, 4% were stages I, II, III and IV, respectively. 25%, 35%, and 40% had grades 1, 2, and 3. Whites were less likely to be diagnosed, and Asians had a nearly 3-fold higher proportion of IT compared to the proportion of Asians in the U.S. census. The 5-year disease-specific survival (DSS) was 91.2%. Those with stages I, II, III and IV disease had survivals of 99.7%, 95%, 81%, and 71.8% (p<0.001) and grades 1, 2, and 3 had DSS of 98.7%, 95.8%, and 91% (p<0.001), respectively. Of those who underwent fertility-preserving surgery, the DSS was 98.8%. Over time from 1973 to 1986, to 1987-1999, to 2000-2012, the survivals were 76.4%, 92.8%, and 94.7% (p<0.001). Of stage I patients, no patient <18years (n=214, used as adult cutoff) and 2 of 283 patients >18years died of cancer, with corresponding 5years DSS of 100% vs. 99.6% (p>0.05). Older age (by year, HR: 1.05; 95% CI: 1.04-1.06; p<0.0001) and higher stage (HR: 11.52; 95% CI: 4.08-32.48; p<0.0001) were independent factors indicating poorer survival. CONCLUSION: The outcome of patients with stage I disease was excellent at 99.7%, with children and adults having corresponding survivals of 100% and 99.6%.

Teratoid cyst of floor of the mouth: a clinicopathologic study of 20 Chinese patients.

The aim of this study is to document the clinicopathologic features of teratoid cyst of the floor of the mouth in 20 Chinese patients, who were treated in Wuhan University. The 20 teratoid cysts were analyzed. All cases were confirmed by pathology. English literature was also reviewed. Our investigations showed that both sexes were equal to have these cysts. The age at diagnosis ranged from 25 days to 34 years, and the greatest frequency was within the first decade. It was found that the congenital cysts were most commonly diagnosed in the midline. All cases were treated by cystectomy, using 1 of the 2 approaches: extraoral or intraoral. Whenever, combined approaches were used in 2 cases. In all, 16 patients were followed-up, and 2 patients had recurrences. The intraoral approach was also effective for the treatment of large lesions and led to very good cosmetic and functional results.

Descriptive epidemiology of teratoma in infants, Hawaii, 1986-2001.

Although teratoma is the most common type of neonatal tumour, there are few population-based epidemiological data on teratoma among infants. Using data from a population-based birth defects registry in Hawaii, this study described the distribution of teratoma with respect to various demographic and clinical factors. A total of 22 cases were identified among deliveries in 1986-2001, of which 13 (59.1%) were located in the sacrococcygeal region. The rate per 10 000 live births was 0.74 for all cases and 0.43 for sacrococcygeal cases. Major birth defects were identified in 7 (31.8%) of the cases. Females accounted for 57.1% of all cases and 58.3% of sacrococcygeal cases. Teratoma rates were highest for Pacific Islanders (1.08) and lowest for Far East Asians (0.37) and Filipinos (0.72). The rate was higher in metropolitan Honolulu (0.89) than in the rest of Hawaii (0.62). Teratoma rates were greater with gestational age < 38 weeks (2.15) than for gestational age >or= 38 weeks (0.34). No clear differences in rates were identified with respect to maternal age, birthweight and plurality. Except for gestational age, the rate differences were not statistically significant. In conclusion, this study found that most of the teratomas among infants occur in the sacrococcygeal region. Differences in teratoma rates were noted with respect to sex, maternal race/ethnicity, geography and gestational age. Due to the small number of cases, caution should be used when interpreting the results. Further investigation involving larger data sets is recommended.

Pattern of ovarian tumours among Malaysian women at General Hospital, Kuala Lumpur.

The objective of this two year retrospective study is to find out the pattern of ovarian tumours among Malaysian women. A total of 280 cases were reviewed. Of these 193 were benign, 81 were malignant and six cases belonged to borderline malignancy. In the general population, equal distribution of serous and mucinous tumours among the benign (15.4%) and malignant (4.3%) types is quite a striking feature. The teratomas were the commonest benign tumour among the Malays and Chinese. Serous cystadenomas were the commonest among the Indians. The Malays had higher incidence of malignant epithelial tumours whereas the Chinese had a higher incidence of metastatic and germ cell tumours. Endometroid tumours occurred from an earlier age of thirty years. There was a preponderance of mucinous tumours among the borderline variety.