Paraneoplastic limbic encephalitis as initial presentation of testicular neoplasm: A case report

Paraneoplastic limbic encephalitis (PLE) is an immunopathologic syndrome associated with malignancy and represents a rare remote outcome of tumor on the nervous system. We report a case of PLE caused by a regressed testicular germ cell tumor in an otherwise healthy young man, who presented with acute-onset confusion, memory impairment and anterograde amnesia. Prompt recognition of PLE is critical as it allows early treatment of both the primary tumor and PLE-related neurologic impairments, which can be severe and irreversible if treatment is delayed. Complete tumor treatment response offers the best chance for neurologic recovery in patients with PLE. To our knowledge, this is the second reported case of PLE with radiologic-pathologic correlation in the setting of a regressed testicular germ cell tumor. •PLE associated with regressed testicular germ cell tumor is exceedingly rare.•Anti-Ma2/Ta antibody is a paraneoplastic antibody associated with testicular tumors in men less than 50 years of age.•Early recognition of PLE allows early diagnosis and treatment of the primary tumor.