J Clin Gynecol Obstet
Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
Journal website https://www.jcgo.org


Volume 10, Number 1, March 2021, page 3

Unusual Presentation of Gynecologic Conditions: Be Very Mindful

G. Willy Davila

Holy Cross Medical Group, Fort Lauderdale, FL, USA

Manuscript submitted February 18, 2021, accepted March 10, 2021, published online March 17, 2021
Short title: Unusual Presentation of Gynecologic Conditions
doi: https://doi.org/10.14740/jcgo733

Gynecologic conditions can be very straight-forward to diagnose, but can also present with very unusual and challenging symptomatology and physical findings. In this issue of the Journal of Clinical Gynecology and Obstetrics (JCGO) we publish a case series of receptor-mediated neuroimmune effects of ovarian teratomas [1]. The young women presented with various neurologic findings including confusion, delirium, altered speech, dyskinesia and seizures. Pelvic imaging revealed adnexal masses which upon removal contained teratomas. Excision of the adnexal mass led to improvement in neuropsychiatric functioning. The condition of N-methyl-D-aspartate (NMDA) receptor autoimmune encephalitis was recognized as a clinical entity in 2007. After reading this paper, one can easily recognize the fact that in the past (and even now) many young women were likely treated as having a primary neurologic or psychiatric condition, and likely did not respond to traditional therapy. Certainly, some underwent very invasive therapies and may have even been institutionalized and never again led a normal life as the teratomas went undiagnosed.

As I perused the literature on this subject, it became clear that the majority of the published literature is in the neurologic or psychiatric literature. Very little is found in the obstetrics and gynecology (OBGYN) literature. This explains why most readers of this journal may never have heard of this condition.

As the primary medical care providers to women, OBGYN clinicians should be familiar with conditions that can lead to serious consequences on women’s health. One can think of atypical presentations of severe pre-eclampsia, undiagnosed advanced pregnancy in a young woman, an undiagnosed ovarian cancer being treated as a gastrointestinal (GI) condition, among many other gynecologic conditions that should not be missed by a woman’s OBGYN clinicians. Unfortunately, atypical presentations frequently lead to a delayed diagnosis and even ineffective therapy.

Journals such as the JCGO have many missions. Top among them is fostering of the education of OBGYN clinicians about the state-of-the-art management of common OBGYN conditions by sharing new research data. In addition, not far from the top is increasing awareness of clinical conditions which can have serious consequences on women’s lives, such that clinical care can be directed at optimizing clinical outcomes. As an old professor of mine in Texas used to say: “Not all that gallops is a horse. Sometimes, it can be a zebra!”


None to declare.

Financial Disclosure

None to declare.

Conflict of Interest

None to declare.

Data Availability

The author declares that data supporting the findings of this study are available within the article.

  1. Thiyagarajan M, Sebastian A, Thomas DS, Thomas A, Peedicayil A, Mathew V. Ovarian teratoma and NMDA receptor autoimmune encephalitis – insights into imaging diagnosis of teratoma and timing of surgery. J Clin Gynecol Obstet. 2021;10(1):22-27.

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Journal of Clinical Gynecology and Obstetrics is published by Elmer Press Inc.


Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics






Journal of Clinical Gynecology and Obstetrics, quarterly, ISSN 1927-1271 (print), 1927-128X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal, the authors retain the copyright, the journal is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International
License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.jcgo.org   editorial contact: editor@jcgo.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.