Paraneoplastic limbic encephalitis (PLE) is a remote, nonmetastatic co
mplication of carcinoma. Neuropsychiatric symptoms usually predate the
diagnosis of cancer by 3 months to 6 years and very rarely the sympto
ms develop after the diagnosis of malignancy. We report the first case
of limbic encephalitis associated with an immature ovarian teratoma.
Within the month following the diagnosis of the tumor with pathologic
stage Ia, somewhat acutely she developed neuropsychiatric symptoms tha
t was exclusively a limbic disorder with impairments in almost every r
ealm of limbic function. This case may show us that it is important to
recognize the neuropsychiatric symptoms of PLE as the first manifesta
tion of a very small malignant ovarian tumor and to aggressively try t
o identify the underlying cancer.