A woman with an ovarian tumor--a teratoma--developed hallucinations and engaged in dangerous behavior. Here's an excerpt from a Cincinnati paper:
"It looked very much like the beginnings of a schizophrenic or bipolar episode," said Christopher Kobet, a fourth-year neurology resident at University Hospital who helped pinpoint Echols' problem.
But the real culprit wasn't in her head: It was a tiny tumor on her left ovary.
The tumor was a teratoma, a freakish, but not uncommon, conglomeration of basic cells growing out of control. Some teratomas, if they're big enough, even contain eyeballs or tiny feet.
Echols' body recognized the tumor as an invader, and developed antibodies against it, just like it would develop antibodies against a cold virus or a form of pollen she might be allergic to.
Those antibodies attacked certain neurochemicals in the brain, triggering the encephalitis and the hallucinations.
Doctors gave Echols steroids to bring down the swelling in her brain, and performed surgery to remove the tumor.
The tumor was so small - less than a centimeter - that it wasn't visible on CT scans, said Ed Richards, the director of gynecologic oncology and advanced pelvic surgery at University. But they knew it had to be there.
He was able to use robotic surgical techniques to find and remove the tumor.
"She was totally insane when she came in, to the point where she would lunge at you, thinking she had to defend herself against you," Richards said. "And a few days after the surgery, she was pretty much back to normal."
Here's another interesting tidbit:
"When I first saw it, I thought it was a once-in-a-lifetime thing, what we call a zebra," Kobet said. "But it's not rare at all."
Now that doctors know it exists and how to test for it, more cases are cropping up.
The implications of not making the right diagnosis are frightening.
"How many women, as recently as the 1950s and 1960s, were institutionalized with this because people thought they were schizophrenic?" Richards asked.