Gynecologic teratomas commonly present with pelvic symptoms. The authors report a case of teratoma causing acute psychosis, encephalopathy, and sudden-onset seizures in a previously healthy 33-year-old woman. After common organic causes were excluded, investigation revealed an immature teratoma containing brain tissue on her left ovary. Anti-N-methyl-D-aspartate receptor encephalitis was diagnosed and, with excision and medical management, her symptoms resolved and she was discharged home in stable condition. Encephalopathy is not commonly attributed to gynecologic causes, but anti-N-methyl-D-aspartate receptor encephalitis may be caused by ovarian teratomas with a neuronal component. Thorough gynecologic examination should be performed on any female patient presenting with new-onset psychosis, encephalopathy, and seizures, especially in the absence of other organic or structural causes. Thus, it is important to look at the whole patient and not just the symptoms.

Introduction: Aggressive angiomyxoma (AAM) is a rare, locally aggressive, benign tumor usually found in the female pelvis. Case Report: We present a 42-year-old Caucasian female undergoing removal of a non-enlarging, painless vulvar mass at time of hysteroscopic endometrial ablation for abnormal uterine bleeding. The patient had a past medical history notable for multiple malignant melanomas. Past surgical history included three low transverse cesarean sections, postpartum tubal ligation, and three wide excisions of melanomas. Family history was negative for dermatologic disease or cancers. The mass had been present for over two years; she desired removal for cosmetic purposes. At the time of surgery, the patient was asymptomatic and physical examination revealed a soft, mobile, approximately 2 cm, non-tender right labial mass. Previous ultrasound report described the mass as 2 × 2 cm and solid-appearing. During the surgery, a 5 × 2.6 × 1.4 cm irregular mass with soft, spongy contents was removed intact via incision followed by blunt and sharp dissection. Pathology of the specimen revealed AAM, with extension of tumor to the surgical margins. Histology and immunohistochemistry reports