Diagnostic and Therapeutic Challenges in Small Cell Carcinoma of the Ovary, Hypercalcemic Type: A Case Report

Abstract

Background: Small Cell Carcinoma of the Ovary, Hypercalcemic Type (SCCOHT) is an uncommon and aggressive cancer predominantly affecting younger women, often linked with poor outcomes. This case elucidates the pivotal diagnostic value of hypercalcemia in young women presenting with ovarian masses, particularly in the context of challenging presentations like primary infertility.

Case Presentation: We report the case of a 30-year-old woman with primary infertility, who was diagnosed with SCCOHT following the identification of symptomatic hypercalcemia. Initially, the hypercalcemia was not evident; however, it became a significant diagnostic clue as the disease progressed. The patient underwent diagnostic evaluations including ultrasonography and contrast-enhanced CT scans. Histopathological and immunohistochemical findings from the adnexal resection specimen, which measured 4 x 3 x 2 cm and exhibited a characteristic small cell morphology with marked nuclear atypia and high mitotic activity, confirmed the diagnosis of SCCOHT.

Discussion: This case delineates the diagnostic intricacies of SCCOHT, spotlighting hypercalcemia as a critical indicator, especially in patients with ambiguous symptoms like infertility. The presence of hypercalcemia in young females with ovarian masses should heighten the suspicion for SCCOHT, emphasizing the necessity for prompt and thorough evaluation. This report enriches the understanding of SCCOHT's clinical and histological manifestations, underlining the imperative for heightened clinical vigilance and swift investigative processes to improve patient outcomes in this aggressive disease.